Related Experiment Video

Updated: Aug 20, 2026

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
09:31

Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography

Published on: January 27, 2023

Effect of chamber capacitance on Doppler flow pattern across restrictive defects in obligatory atrial-level shunts

Alessandro Giardini1, Boris Schmitt, Anthony Azakie

  • 1Pediatric Cardiology and Adult Congenital Unit, University of Bologna, Italy.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|November 25, 2004
PubMed

Insights

Atrial capacitance impacts Doppler flow patterns across atrial septal defects (ASDs) in unilateral atrioventricular (AV) valve atresia. Findings suggest Doppler assessment of ASD adequacy may be unreliable in right AV valve atresia (RAVVA).

Area of Science:

  • Cardiology
  • Medical Imaging
  • Hemodynamics

Background:

  • Right atrium has higher capacitance than the left atrium.
  • This difference may influence Doppler flow patterns across atrial septal defects (ASDs) in unilateral atrioventricular (AV) valve atresia.
  • Doppler flow patterns are commonly used to evaluate ASD adequacy in this condition.

Purpose of the Study:

  • To investigate the influence of atrial capacitance and ASD size on trans-ASD Doppler flow patterns.
  • To compare these patterns in in vivo flow models of left AV valve atresia (LAVVA) and right AV valve atresia (RAVVA).

Main Methods:

  • Utilized in vivo flow models simulating LAVVA and RAVVA.
  • Assessed trans-ASD Doppler flow patterns using the max/min velocity ratio.
  • Measured mean interatrial pressure gradients (PGs).

Main Results:

  • ASD flow rate correlated with mean trans-ASD PG in both models.
  • LAVVA models showed a higher slope of this correlation compared to RAVVA.
  • LAVVA consistently exhibited persistent PG with a low max/min velocity ratio (median 1.46).
  • RAVVA frequently demonstrated phasic flow with a high max/min velocity ratio (median 8.0).

Conclusions:

  • Atrial capacitance significantly affects mean PG and Doppler flow patterns across ASDs.
  • Doppler findings in RAVVA, characterized by high max/min velocity ratios, may not accurately reflect ASD adequacy.
  • Relying solely on Doppler assessment for ASD adequacy in RAVVA is not recommended.

More Related Videos

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure07:41

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure

Published on: February 8, 2022

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation08:10

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

Related Concept Videos

Chambers of the Heart01:16

Chambers of the Heart

The human heart is a complex organ made up of four chambers: the right and left atria and the right and left ventricles. These internal chambers are separated by partitions known as the interatrial and interventricular septa. The exterior of the heart features a groove known as the coronary sulcus that demarcates the atria from the ventricles, while the anterior and posterior interventricular sulci distinguish between the two ventricles.
Deoxygenated blood from the body is received in the right...
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
Dysrhythmias IV: Characteristics of Bradyarrhythmias01:18

Dysrhythmias IV: Characteristics of Bradyarrhythmias

Bradyarrhythmias are cardiac rhythm disorders characterized by a slower-than-normal heart rate, typically defined as fewer than 60 beats per minute. Some of which are discussed here:Sinus BradycardiaSinus bradycardia presents a heart rate lower than 60 beats per minute, with a regular rhythm originating from the SA node. The ECG typically shows normal P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and a normal QRS duration (0.06 to 0.10 seconds).First-Degree AV...
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...