Doppler Echocardiographic Comparison of Flows Distal to the Four Cardiac Valves

Cardiac flows measured by the Doppler technique and invasive methods correlate well, but no prior study has correlated Doppler flows obtained distal to the four cardiac valves in the same individual. The purpose of this investigation was to measure the four flows in normal subjects using the range-gated pulsed Doppler echocardiographic technique. Velocities were obtained from 22 subjects aged 4 to 29 years at a beam-flow intercept angle close to 0 degree in the ascending aorta, distal main pulmonary artery and the tricuspid and mitral valve outflow areas. Vessel and orifice sizes of the ascending aorta, main pulmonary artery and tricuspid valve orifice were measured directly from two-dimensional echocardiographic images. The mitral valve orifice was measured by a previously described method. Results show that flow values for the ascending aorta, main pulmonary artery and tricuspid valve inflow area were similar in absolute magnitude and correlated strongly (r = 0.93 to 0.98). Slopes for these relations were approximated at 1.0. The absolute magnitude of mitral valve flows was highly variable and showed the poorest correlation with flows from the other areas (r = 0.59 to 0.67). The high correlation of ascending aorta, main pulmonary artery and tricuspid valve outflow areas was considerably assisted by recording of velocity at a verified angle near 0 degree and obtaining accurate vessel and valve diameters. Improved angle accuracy was possible in the ascending aorta with the use of a new transducer designed to image anteroinferiorly from the suprasternal notch. A relatively simple method for measuring tricuspid flow was developed.(ABSTRACT TRUNCATED AT 250 WORDS)