Intracardiac flow dynamics with bi-directional ultrasonic pulsed Doppler technique.

1) Intracardiac flows were investigated by bi-directional pulsed Doppler technique with a combined use of the two-dimensional echocardiography. The flow at sampling sites in the heat and great vessels were correctly identified on the two-dimensional echocardiograms. 2) Soundspectrographic analysis of the flow Doppler signals was useful in obtaining information about flow modes and in differentiating flow signals from those of valves. 3) In healthy subjects, intracardiac flow revealed a laminar mode. As a matter of interest, a flow toward the aorta, which is a cranially turned flow, was found at the center and at the outflow tract of the left ventricle from mid to late diastole. 4) In mitral stenosis, the central stream at the stenotic portion exhibited an almost laminar and rapid flow. A good coincidence in flow mode was observed between clinical cases of mitral stenosis and experimental stenosis. 5) Disturbed flows were observed in the following diseased conditions. The diastolic regurgitant flow in the left ventricular outflow tract and mitral inflow in aortic regurgitation, the regurgitant flow into the left atrium and the diastolic mitral inflow in mitral regurgitation, the ejection flow in hypertrophic cardiomyopathy with outflow tract obstruction, and the tricuspid inflow in atrial septal defect. 6) Mechanisms of intracardiac flow dynamics were also discussed.