2023 Korean Society of Echocardiography position paper for the diagnosis and management of valvular heart disease, part II: mitral and tricuspid valve disease

Table 4 Stages of chronic primary mitral regurgitation

Characteristic	Stage
	A	B		C1	C2	D
Definition	At risk	Progressive		Asymptomatic severe		Symptomatic severe
Severity	Normal to insignificant	Mild	Moderate	Severe
Echocardiography morphology
Leaflet	Mild thickening or restriction	Moderate to severe thickening or restriction		Severe thickening or restriction
Prolapse	Mild	Moderate to severe		Severe
Coaptation	Normal	Moderate to severe loss		Severe loss
VCW (mm)	< 3	3–7		≥ 7
EROA (cm²)	< 0.2	0.2–0.3	0.3–0.4	≥ 0.4
Regurgitant volume (mL)	< 30	30–44	45–59	≥ 60
Regurgitant fraction (%)	< 30	20–39	40–49	≥ 50
LVEF (%)	Normal	Normal		> 60	≤ 60	-
LVESD (mm)	Normal	Normal		< 40	≥ 40	-
LA size	Normal	Normal or ↑		↑
LV size	Normal	Normal		↑
PV flow	Systolic dominance	Normal or systolic blunting		Systolic flow reversal
Symptom	None	None		None		DOE, EI

VCW Vena contracta width, EROA Effective regurgitant orifice area by 2D-PISA method, Reg. Regurgitant, LVEF Left ventricular ejection fraction, LVESD Left ventricular end-systolic dimension, LA Left atrium, LV Left ventricle, PV Pulmonary vein, DOE Dyspnea on exertion, EI Exercise intolerance

ISSN: 2586-7296