Comparison of Doppler-derived peak aortic velocities obtained from subcostal and apical transducer sites in healthy dogs.

The accuracy of Doppler-derived blood flow velocity depends on the angle of incidence between the ultrasound beam and the direction of flow. In dogs with subaortic stenosis, it is known that the subcostal transducer site provides higher left ventricular ejection velocities than does the apical site. Left ventricular ejection velocities obtained from the subcostal site in healthy dogs have not been reported; accordingly, we examined healthy, random-source dogs to test the hypothesis that aortic velocities obtained from the subcostal and apical transducer sites differ. In 38 unsedated dogs, high-pulsed repetition frequency (HPRF) and continuous-wave (CW) Doppler studies of the proximal aorta and left ventricular outflow tract were performed using two-dimensional echocardiographic guidance. The effects of Doppler modality, transducer site, and their interaction on peak aortic velocity were tested through the use of analysis of variance. P values less than 0.05 were considered to indicate significance. The mean (+/-SE) peak aortic velocities were as follows: subcostal site (HPRF) = 1.44 +/- 0.03; apical site (HPRF) = 1.39 +/- 0.03; subcostal site (CW) = 1.48 +/- 0.03; apical site (CW) = 1.39 +/- 0.03. Aortic velocities obtained from the subcostal site were significantly greater than those obtained from the cardiac apex (P = 0.0001). Lower and upper limits of 95% reference intervals for aortic velocities by method of measurement and transducer location are proposed. In a population of healthy dogs, peak aortic velocities obtained from the subcostal site exceeded those obtained from the cardiac apex but did so only to a marginal degree.