The presence of certain findings determined by 2-dimensional echocardiography may indicate a risk for adverse outcomes in a patient with asymptomatic aortic regurgitation. Donovan and Starling developed an algorithm to help decide if the level of risk posed by these factors is sufficient to justify surgery or not.
Parameters:
(1) percent fractional shortening
(2) end-systolic volume index in mL per square meter BSA
(3) end systolic wall stress in mm Hg
(4) end-diastolic wall dimension in mm
(5) ratio of the end diastolic dimension (radius) to end-diastolic wall thickness
Parameter
Finding
Points
percent fractional shortening
>= 30%
0
< 29%
2
end systolic volume index
<= 60 mL per square m
0
> 60 mL per square m
2
end systolic wall stress
<= 235 mm Hg
0
> 235 mm Hg
2
end diastolic wall dimension
<= 80 mm
0
> 80 mm
2
ratio of end diastolic dimension to end diastolic wall thickness
< 3.2
0
>= 3.2
2
total score for adverse outcome =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk for an adverse outcome.
To read more or access our algorithms and calculators, please log in or register.
