Recommendations for Noninvasive Evaluation of Native Valvular Regurgitation , JASE, April 2017
A Report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Magnetic Resonance
Valvular regurgitation continues to be an important cause of morbidity and mortality. While a careful history and physical examination remain essential in the overall evaluation and management of patients with suspected valvular disease, diagnostic methods are often needed and are crucial to assess the etiology and severity of valvular regurgitation, the associated remodeling of cardiac chambers in response to the volume overload, and the characterization of longitudinal changes for optimal timing of intervention. In 2003, the American Society of Echocardiography along with other endorsing organizations provided, for the first time, recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional (2D) and Doppler echocardiography. Advances in three-dimensional (3D) echocardiography and cardiovascular magnetic resonance (CMR) have occurred in the interim that provide additional tools to further delineate the pathophysiology and mechanisms of regurgitation and supplement current methods for assessing regurgitation severity. Furthermore, within this time frame, critical information linking Doppler echocardiographic measures of regurgitation severity to clinical outcome has been published. This update on the evaluation of valvular regurgitation is a comprehensive review of the noninvasive assessment of valvular regurgitation with echocardiography and CMR in the adult. It provides recommendations for the assessment of the etiology and severity of valvular regurgitation based on the literature and a consensus of a panel of experts.