Pulmonic Regurgitation

Pulmonary Regurgitation

Least likely to have significant regurgitation - likely mild

Trivial-Mild PR

Seen in 75% of the population

2D Features of Chronic PR

RV dilation with normal function - overload

Jet Width to RVOT annulus ratio for Severe PR

≥ 70%

Vena Contracta for PR

Measure in PSAX

Must see flow convergence, neck, and PR jet

VCW to PV annulus diameter ratio for Severe PR

> 50%

Spectral Doppler Features of Severe PR

Brighter/denser signal

Rapid deceleration

Flow Reversal in Pulmonary Artery Branches

Indicates severe PR

Pressure Half Time for PR

Calculated from deceleration time tracing of the slope

Shorter PHT = more severe PR

PHT or DT for Severe PR

< 100 msec or < 260 msec

PR Index

Ratio of PR duration to total diastolic duration

PR Index for Severe PR

< 0.77

Regurgitant Fraction for PR

Not validated yet

Uses stroke volume to calculate RF

Why is the Stroke Volume difficult to calculate for the RVOT?

The RVOT changes size during each cardiac cycle

RF for Mild PR

< 20%