 Regurgitant volume

Regurgitant volume is the amount of blood transported backward through a leaking heart valve over a specified interval, usually a cardiac cycle. In mitral regurgitation, it is backward transport from the left ventricle towards the left atrium during ventricular systole. It measures an integrated volume rather than a peak velocity or one still image of the jet.

For a fixed measurement surface with normal pointing in the backward direction, the instantaneous backward flux is the surface integral of the corresponding positive normal velocity. Integrating over time givesA moving surface instead requires velocity relative to that surface. This convention separates material transported through a boundary from the motion of the boundary itself.

An imaging estimator combines an effective regurgitant orifice area with a velocity-time integral. If the effective area is approximately constant over the interval,The technical recommendations describe this area-times-integrated-velocity approach and complementary volumetric methods.^[ref]

For stipulated $A_{\mathrm{eff}}=0.20\mathrm{c}{\mathrm{m}}^2$ and VTI 150 cm, the estimate is $30\mathrm{c}{\mathrm{m}}^3=30$ mL. Equal peak velocities do not ensure equal VTI: two triangular velocity pulses of height 5 m/s and durations 0.10 and 0.20 s have integrals 25 and 50 cm. At the same effective area, their modeled backward volumes are 5 and 10 mL. These are illustrative pulses, not observed valve measurements.

A changing effective area cannot generally be pulled out of the time integral. A peak-area measurement multiplied by the full VTI can therefore answer a different question from integrating the changing area and velocity together. Independently, the ventricular balance $V_R=V_T-V_F$ requires compatible total and forward stroke volumes. The regurgitant fraction then divides $V_R$ by the relevant total volume; it does not replace the underlying amount measurement.