Continuous wave Doppler tracing from apical five chamber view

Continuous wave Doppler tracing from apical five chamber view

Continuous wave Doppler tracing showing AS and AR high velocity jets

​Continuous wave Doppler tracing showing aortic stenosis and regurgitation jets.

The aortic regurgitation jet has a rapid rise in velocity after the aortic valve closes and then a slow decline till the end of diastole. The decline in velocity is faster in those with severe aortic regurgitation [1].

The pressure half time is shorter in severe aortic regurgitation (less than 200 ms) and above 500 ms in mild aortic regurgitation. ​Continuous wave Doppler tracing is needed for evaluating these high velocity jets because the velocity range is quite above the aliasing velocity of pulsed Doppler.

Here the density of the AR jet is low indicating a lower severity of AR. Pressure half time is in the range for moderate AR. In this situation, elevated aortic forward gradient would suggest some degree of aortic stenosis. The actual severity of AS has to be assessed by calculating the aortic valve area. There could be discordance between the gradient and severity of AS as in low flow low gradient aortic stenosis.

Reference

  1. Masuyama T, Kodama K, Kitabatake A, Nanto S, Sato H, Uematsu M, Inoue M, Kamada T. Noninvasive evaluation of aortic regurgitation by continuous-wave Doppler echocardiography. Circulation. 1986 Mar;73(3):460-6.