60/60 sign (echocardiography)

David Carroll et al.

The 60/60 sign in echocardiography refers to the coexistence of a shorted right ventricular acceleration time with a discordant, low velocity tricuspid regurgitant jet. A finding 94% specific for acute cor pulmonale due to pulmonary embolism, the tricuspid regurgitant (TR) jet will be <60 m/s (and above 30 m/s) and the right ventricular outflow tract (RVOT) acceleration time will be <60 ms 1.

Faced with a chronic elevation in pulmonary arterial pressures, the right heart generates increased pressures; in this context, tricuspid regurgitant velocities (>60 m/s) increase commensurate with increased right ventricular systolic pressure (RVSP) and the RVOT acceleration time decreases as a reflection of increased mean pulmonary arterial pressure (mPAP) 2

In the setting of acute cor pulmonale, the right heart lacks the capacity to increase pressure proportionate to afterload. The RVOT acceleration time will shorten, but does not reflect a true increase in pressure. Interrogation of the tricuspid regurgitant jet will characteristically reveal a velocity below 60 m/s, confirming the lack of a significant rise in pulmonary artery systolic pressure (sPAP).

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Article information

rID: 65879
System: Cardiac
Section: Signs
Synonyms or Alternate Spellings:
  • Sixty-sixty sign (echo)
  • 60/60 (echo)
  • 60-60 sign (echo)

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