CSE - CardioMath

Aortic Valve Velocity Ratio	LV EF (Modified Quinones Equation)	Myocardial Performance Index (RV)
AVA (Continuity Equation VTI)	LV EF (Simplified Quinones Equation)	PCWP by E/Ea (Nagueh Formula)
AVA (Continuity Equation V_Max)	LV Fractional Shortening	PISA (Mitral regurgitation)
dP/dt (LV contractility)	LV Mass and LV Mass Index	PISA (Mitral stenosis)
dP/dt (RV contractility)	Mitral valve area (PHT)	Qp/Qs
Left atrial pressure (MR)	Mitral Valvuloplasty Score (MGH)	RVSP (TR)
LA Volume (Biplane Method)	Modified Bernoulli Equation	Stroke Volume, Cardiac Output
LV EF (Dumesnil Method)	Myocardial Performance Index (LV)

PISA Method in Quantitating Mitral Regurgitation

r				cm
V_r				cm/s
V_Max				m/s
VTI				cm

VFR				mL/s
ERO				mm²
RVol				mL

Mitral Regurgitation Grade of Severity

	ERO (mm²)	RVol (mL/beat)
Mild	<20	<30
Mild-Moderate	20-29	30-44
Moderate-Severe	30-39	45-59
Severe	≥40	≥60

PISA (Mitral Regurgitation)

Quantification of mitral regurgitation using the principle of conservation of mass by analyzing the Proximal Isovelocity hemispheric Surface Area of the flow convergence on the ventricular side. This method is more accurate for central regurgitant jets than eccentric jets, and for a circular orifice than a non-circular orifice.

VFR =

2 * π * r² * V_r

ERO =

VFR

V_Max

RVol =

ERO * VTI

Variable	Definition
Input
2 × π × r²	Proximal isovelocity hemispheric surface area at a radial distance r from the orifice
V_r	Aliasing velocity at the radial distance r (cm/s)
V_Max	Peak velocity of the mitral regurgitant jet (m/s)
VTI	VTI of the mitral regurgitant jet (cm)
Output
VFR	Volume Flow Rate (mL/s)
ERO	Effective Regurgitant Orifice (mm²)
RVol	Regurgitant Volume (mL/beat)

References

	Zoghbi WA et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional Doppler Echocardiography. J Am Soc Echocardiogr 2003; 16(7):783-5,787.

	Enriquez-Sarano M., et al. Effective mitral regurgitation orifice area: clinical use and pitfalls of the proximal isovelocity surface area method. JACC 1995; 23(3):703-9.

	Utsonomiya T et al. Doppler color flow "proximal isovelocity surface area" method for estimating volume flow rate: effect of orifice shape and machine factors. JACC 17:1103, 1991.

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Author: Dr. Chi-Ming Chow

Developer: Edward Brawer

Disclaimer: The calculators provided are not meant to be a substitute for professional advise and are not to be used for medical diagnosis. All calculations must be confirmed before clinical use or diagnostic purposes by qualified medical professionals. The authors make no claims of the accuracy of the information contained herein. The authors make no claims whatsoever, expressed or implied, about the authenticity, accuracy, reliability, completeness or timeliness of the material, software, text, graphics and links given. In no event shall the authors, its suppliers, affiliates or any third parties be liable in any manner whatsoever for any damage arising upon use of any information provided.