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Table 6 ACC/AHA guidelines for grading severity of MR [30]

From: Cardiovascular magnetic resonance in the evaluation of heart valve disease

 

Mild

Moderate

Severe

Qualitative

 Angiographic grade

1+

2+

3-4+

 Colour Doppler jet area

Small, central jet (<4cm2 or <20% LA area)

Signs of MR greater than mild present, but no criteria for severe MR.

Vena contracta width greater than 0.7 cm with large central MR jet (area < 40% of LA area) or with a wall-impinging jet of any size, swirling in LA.

 Doppler vena contracta width (cm)

<0.3

0.3-0.69

≥0.7

Quantitative (cardiac catheterisation or echo)

 Regurgitant volume (ml)

<30

30-59

≥60

 Regurgitant fraction (%)

<30

30-49

≥50

 Regurgitant orifice area (cm2)

<0.2

0.2-0.39

≥0.4

Additional essential criteria

 LA size

  

Enlarged

 LV size

  

Enlarged