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Mitral or Tricuspid Doppler Flow

Measurement

  1. 4 chamber view
  2. Check valve abnormality and regurgitation with 2D visual inspection and flow color
  3. PW doppler gate at just below tip of mitral or tricuspid valve
  4. Sweep speed may need to be adjusted

E/A = Peak velocity of E wave / Peak velocity of A wave

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Mitral or Tricuspid Doppler Flow (Early Postnatal Normal Value)

Preterm

Birth

Age (days)

E (cm/sec)

A (cm/sec)

E/A

<1,000 g

13±10

32.7±12.3

36.9±43.6

​

1000-1499 g

12±9

38.5±11.4

43.6±11.9

​

26-32 weeks

14±4

31.0±9.0

33.0±7.0

0.93±0.19

32-36 weeks

≤ 4

40.1±5.6

43.2±6.0

0.93±0.03

Practical Neonatal Echocardiography. Editor Siassi B, 2019

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Mitral or Tricuspid Doppler Flow (Late Postnatal Normal Value)

Preterm

Birth

Age (days)

E (cm/sec)

A (cm/sec)

E/A

<1,000 g

132±33

82.0±14.5

66.5±24.5

​

1000-1499 g

138±70

79.0±10.9

75.1±10.7

​

26-32 weeks

94±17

78.0±14.0

61.0±12.0

1.29±0.18

32-36 weeks

30

61.5±5.2

56.9±4.8

1.08±0.04

Practical Neonatal Echocardiography. Editor Siassi B, 2019

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Mitral or Tricuspid Doppler Flow (Early Postnatal Normal Values)

Term

Age (days)

E (cm/sec)

A (cm/sec)

E/A

≤ 5

46.9±5.2

44.3±5.7

1.06±0.05

7±1

58.0±8.0

49.0±10.0

1.21±0.21

15±14

56.2±16.4

50.8±13.9

​

Practical Neonatal Echocardiography. Editor Siassi B, 2019

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Mitral or Tricuspid Doppler Flow (Early Postnatal Normal Values)

Term

Age (days)

E (cm/sec)

A (cm/sec)

E/A

30

62.8±6.1

56.9±5.4

1.11±0.05

135±36

86.2±10.5

70.6±13.1

Practical Neonatal Echocardiography. Editor Siassi B, 2019

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Pulmonary Vein Doppler

Measurement

  • 4 chamber view
  • PW doppler gate at pulmonary vein (the most vertical one)
  • Measure peak velocity of S, D, A wave (average of 3 cycles)
  • Measure duration of A wave

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Pulmonary Vein Doppler (Interpretation)

  • Poor LV diastolic function leads to increased LA pressure and decreased pulmonary vein flow
  • Increased LA pressure resulted in D > S wave
  • Other causes of increased LA pressure = mitral valve regurgitation/stenosis, high preload

In normal newborn, S wave could be slightly less than D wave

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Pulmonary Vein Doppler (Interpretation)