Pulsed Doppler regurgitant flow patterns of normal valves

Although Doppler echocardiography allows recording of regurgitant turbulent flow patterns in normal persons, sparse information is available concerning the incidence, characteristics and mechanism of these flow patterns. Therefore, pulsed Doppler echocardiograms were recorded in 25 normal persons to detect regurgitation. A regurgitant turbulent flow pattern was recorded at the pulmonic valve in 23 subjects (92%), covered up to 81% of the diastole and could never be recorded in early diastole. An early to midsystolic regurgitant flow pattern was recorded at the mitral valve in 10 subjects (40%) and covered up to 60% of systole. A similar regurgitant flow was recorded at the tricuspid valve in 11 subjects (44%) and was holosystolic in 1 subject. An early diastolic regurgitant flow with low maximal velocities and rapid decrease in velocities was recorded at the aortic valve in 8 subjects (33%) and covered up to 26% of the diastole. In no person could those flows be recorded farther than 1 cm proximal to the valve closure. Whatever the still-debated mechanisms of those regurgitant flow patterns in normal subjects, one should be aware of their existence and characteristics when assessing valvular function by Doppler.