New index for grading the severity of aortic regurgitation based on the cross-sectional area of vena contracta measured by color Doppler flow mapping

This study was designed to examine whether the cross-sectional area of vena contracta measured by color Doppler flow mapping (CFM) could be used for assessing aortic regurgitation (AR) and developing an index for grading AR. The 75 study patients with AR were classified into quadrant grades according to New York Heart Association functional class, regurgitant fraction, left ventricular (LV) end-diastolic dimension and LV end-systolic dimension. Using CFM, the cross-sectional area of the vena contracta was measured and it could distinguish all grades without significant overlap. An area of less than 0.10cm(2) corresponded to Grade 1, 0.10-0.19cm(2) corresponded to Grade 2, 0.20-0.29 cm(2) corresponded to Grade 3 and an area of more than 0.30 cm(2) corresponded to Grade 4. An area of vena contracta of more than 0.30 cm(2) identified high-scoring AR (Grade 4) in 11 of 11 (sensitivity 100%) and correctly predicted the absence of high-scoring AR in 60 of 64 (specificity 94%). Conversely, there was considerable overlap between the jet distances with the clinical grades. The cross-sectional area of the vena contracta measured by CFM can provide a simple quantitative assessment of AR that correlates well with the clinical grade of AR.