Points
Acquisition is performed in the apical 4-chamber view, using color flow imaging.
The M-mode scan line is placed through the center of the LV inflow blood column from the mitral valve to the apex, with baseline shift to lower the Nyquist limit so that the central highest velocity jet is blue.
Flow propagation velocity (Vp) is measured as the slope of the first aliasing velocity during early filling, measured from the mitral valve plane to 4 cm distally into the LV cavity, or the slope of the transition from no color to color.
Vp >50 cm/s is considered normal.
In most patients with depressed EFs, Vp is reduced, and should other Doppler indices appear inconclusive, an E/Vp ratio ≥2.5 predicts PCWP >15 mmHg with reasonable accuracy.
Patients with normal LV volumes and EFs but elevated filling pressures can have misleadingly normal Vp.