From the Guidelines
The normal range for aortic transvalvular peak velocity measured with Doppler by TTE is less than 2.0 m/s, as values between 2.0–2.9 m/s are considered indicative of moderate aortic stenosis. This measurement is crucial for assessing the severity of aortic stenosis, with higher velocities corresponding to more severe disease 1. The guidelines for the management of grown-up congenital heart disease provide diagnostic criteria for the degree of aortic stenosis severity, including the maximum Doppler velocity (Vmax) 1.
Key Points to Consider
- The maximum Doppler velocity (Vmax) is a key parameter in assessing aortic stenosis severity, with values ≥4.0 m/s indicating severe stenosis 1.
- The normal transvalvular flow is typically characterized by a Vmax of less than 2.0 m/s 1.
- It is essential to consider the clinical context and potential factors that may influence the measurement, such as high-output states or technical limitations 1.
Clinical Implications
- Accurate measurement of aortic transvalvular peak velocity is vital for diagnosing and managing aortic stenosis, as it guides treatment decisions and predicts outcomes 1.
- The use of Doppler echocardiography by TTE provides a non-invasive and reliable method for assessing aortic valve function and detecting potential abnormalities 1.
From the Research
Normal Range for Aortic Transvalvular Peak Velocity
The normal range for aortic transvalvular peak velocity measured with Doppler by TTE is not explicitly stated in the provided studies. However, some studies provide information on the peak jet velocity in healthy adults or patients with aortic stenosis:
- A study from 1992 2 measured the maximal flow velocities in the ascending aorta from the suprasternal position in 40 healthy adults and found a mean value of 1.28 +/- 0.18 m/s.
- Another study from 2022 3 calculated peak jet velocity (Vmax) in 5994 adult subjects with and without aortic stenosis, but did not provide a specific normal range for Vmax.
Factors Influencing Aortic Transvalvular Peak Velocity
Some factors that can influence the measurement of aortic transvalvular peak velocity include:
- Imaging window: A study from 2015 4 found that the highest peak jet velocity was most frequently obtained in the right parasternal window, followed by the apex.
- Aortic root angulation: The same study found that aortic root angulation influenced the location of the highest peak jet velocity.
- Valve area: A study from 1988 5 found that Doppler-derived aortic valve area correlated well with catheterization-derived aortic valve area.
Comparison of Doppler-Derived Values
Some studies compared Doppler-derived values with other methods, such as:
- Catheterization: A study from 1988 5 found that Doppler-derived mean gradient correlated well with corresponding gradient by catheterization.
- Cardiovascular magnetic resonance (CMR): A study from 2011 6 found a good correlation and concordance between TTE-derived and CMR-derived effective orifice areas.