Valvular Heart Disease: Classification

Heart valve defects (HKF) can be classified into the following severity levels according to the New York Heart Association (NYHA):

NYHA Complaint level
I No complaints
II Complaints during heavy exertion
III Complaints during light exertion
IV Complaints at rest

Aortic valve stenosis can be classified as follows:

Grade KÖF* (cm²) KÖF/body surface (cm²/m²) Mean pressure difference (mmHg) Maximum transvalvular flow velocity (m/s)
Light > 1,5 > 1,0 < 25 < 3,0
Medium 1,0- 1,5 0,6-1,0 25-50 3,0-4,0
Heavy < 1,0 < 0,6 > 50 > 4,0

* KÖF = valve orifice areaAortic valve regurgitation can be classified as follows:

Grade Regurgitation fraction
I < 20 %
II 20-39 %
III 40-60 %
IV > 60 %

Mitral stenosis can be classified as follows:

Grade Mitral orifice area (cm²) Mean pressure gradient (mmHg) Mean pulmonary capillary pressure under stress (mmHg)
Slightly < 8 > 1,5-2,5 < 21
Medium 8-15 1,0-1,5 21-25
Heavy > 15 < 1,0 > 25

Mitral regurgitation can be classified as follows:

Grade Regurgitation fraction
I < 20 %
II 20-39 %
III 40-60 %
IV > 60 %