1. Color Doppler: Jet Width & Vena Contracta
- Jet Width / LVOT Diameter Ratio
- Mild: <25%
- Moderate: 25–64%
- Severe: ≥65%
- Vena Contracta Width
- Mild: <0.3 cm
- Moderate: 0.3–0.6 cm
- Severe: >0.6 cm
2. Pressure Half-Time (PHT)
- Measures rate of pressure equalization between LV & aorta.
- Mild: >500 ms
- Moderate: 200–500 ms
- Severe: <200 ms
3. Holodiastolic Flow Reversal (Descending Aorta)
- PW Doppler in descending aorta:
- Absent or brief: Mild
- Holodiastolic reversal: Severe
4. Regurgitant Volume & Fraction
- Regurgitant Volume (RVol)
- Mild: <30 mL
- Moderate: 30–59 mL
- Severe: ≥60 mL
- Regurgitant Fraction (RF)
- Mild: <30%
- Moderate: 30–49%
- Severe: ≥50%
5. LV Size & Function
- Chronic severe AR → LV dilation (LVEDD >65 mm, LVESD >50 mm).
- EF typically preserved until late; declining EF suggests decompensation.
Severe AR usually shows
- Wide jet (>65% LVOT)
- Vena contracta >0.6 cm
- PHT <200 ms
- Holodiastolic flow reversal
- RVol ≥60 mL or RF ≥50%
- LV dilation +/- decreased EF