Table 2 Stages of chronic aortic regurgitation

Definition

At risk

Progressive

Asymptomatic severe

Symptomatic severe

Severity

Normal to none

Mild

Moderate

Severe

Echocardiography

 Morphology

  Leaflet

Congenital, BAV, sclerosis

Calcification or rheumatic changes

Severe calcification or rheumatic changes

  Sinus/ascending aorta

-

Dilated

Dilated

 Vena contracta width (mm)

-

<3

3–6

≥6

 Jet width (% of LVOT)

-

<25

25–64

≥65

 JCSA (% of LVOT)

-

<5

5–59

≥60

 EROA (cm²)

-

<0.1

0.1–0.3

≥0.3

 Regurgitant volume (mL)

-

<30

30–59

≥60

 Regurgitant fraction (%)

-

<30

30–49

≥50

 Diastolic flow reversal^b

-

Brief, early

Intermediate

Holodiastolic (end-diastolic velocity >20 cm/sec)

 LVEF (%)

Normal

Normal

>50

≤50

Any

 LVESD (mm)

Normal

Normal

<50

>50 (25^a)

Dilation ↑↑

Symptom

None

None

None

DOE, Angina, HF