Regurgitação aórtica: Como classificar.

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Aqui.
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Comparison of Semiquantitative and Quantitative Assessment of Severity of Aortic Regurgitation: Clinical Implications
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The mean effective regurgitant orifice area was 25 ± 14 mm2 (range, 3–69 mm2), the mean regurgitant volume was 57 ± 31 mL (range, 9–183 mL), and 100 patients (44%) had severe AR (effective regurgitant orifice area ≥ 30 mm2 or regurgitant volume ≥ 60 mL). Overall, semiquantitative methods had good specificity but poor sensitivity, except the vena contracta, which had good sensitivity and specificity. Sensitivity, specificity, and positive and negative predictive values of the recommended thresholds for severe AR of the four semiquantitative methods were 53%, 89%, 77%, and 73% for left ventricular cardiac output ≥ 10 L/min; 12%, 100%, 100%, and 52% for pressure half-time < 200 msec; 45%, 87%, 79%, and 60% for diastolic flow reversal ≥ 18 cm/sec; and 81%, 83%, 78%, and 85% for vena contracta ≥ 6 mm, respectively. Conclusions For the assessment of AR severity, current thresholds appear specific but poorly sensitive, except for vena contracta, which provides good discriminative value. Semiquantitative methods should be integrated into the comprehensive evaluation of AR severity, but severe AR should not be excluded only on the basis of semiquantitative criteria. These results emphasize the need for the quantitative assessment of AR severity. . Apesar das críticas, o artigo mostra a Vena Contracta como excelente ferramenta para avaliação da regurgitação aórtica.
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É claro que o uso do PISA e os valores "quantitativos" podem ser mais específicos mas uma análise de insuficiência aórtica moderada ou acentuada envolve avaliações também do volume ventricular, refluxo na aorta descendente e abdominal e área do color na via de saída, pelo menos, em adição aos parâmetros semiquantitativos utilizados.
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