Normal left ventricular Doppler flow patterns

With the Doppler beam directed from apex to base, a variety of Doppler flow velocity patterns within the left ventricle (LV) can be obtained. The position of the sample volume for recording each of these patterns is shown in the diagram of an apical "five-chamber" view. Pattern #1 is flow within the left ventricular (or mitral valve) inflow tract (LVIT) as recorded from the tip of the mitral valve on its left ventricular side. The M-shaped inflow pattern is nearly identical to the M-mode image of mitral leaflet motion. The initial velocity peak represents the highest velocity achieved during the passive or rapid filling (RF) phase; the lower peak velocity represents the atrial (A) inflow phase. Although there is similarity in the appearance between the mitral M-mode motion and Doppler flow signals, there is very little predictive value of one for the other. Pattern #3 is flow within the left ventricular outflow tract (LVOT), representing systolic flow leaving the LV; this systolic signal demonstrates flow away from the transducer or away from the apex. Pattern #2 (LVIT/LVOT) is a hybrid mixture of #1 and #3 and gives inaccurate information about either. It is important to sample the Doppler flow signal axial to its flow.