Table 1

Grading of pulmonary regurgitation by echo Doppler studies

NoneNo pulmonary regurgitation on Doppler study
Grade IPulmonary regurgitation jet width ⩽ 10% of pulmonary valve annulus diameter in precordial short axis view
No right ventricle volume overload
Grade IIPulmonary regurgitation jet width 11–25% of pulmonary valve annulus diameter
No right ventricle volume overload
Grade IIIPulmonary regurgitation jet width 26–50% of pulmonary valve annulus diameter
No right ventricle volume overload but with or without flat septal motion
Grade IVPulmonary regurgitation jet width > 50% of pulmonary valve annulus diameter
Right ventricle volume overload present
  • Jet width at the origin of regurgitation jet rather than jet length was used for grading because the jet width is not influenced by pulmonary artery pressures.

  • Right ventricle volume overload is defined as enlarged right ventricle (> 95 percentile) and flat to paradoxical septal motion.