Hemodynamic correlates of the normal aortic valve echogram. A study of sound, flow, and motion.

The aortic valve echogram was recorded in open chest dogs simultaneously with aortic flow, acceleration of flow, aortic and left ventricular pressures, and intracardiac phonocardiograms. Comparison of echographic with hemodynamic data showed the following: The aortic valve started its opening with the onset of flow, at the same point that left ventricular pressure exceeded aortic pressure. Complete valve opening preceded peak aortic flow by an average of 43 msec and the cusps started to move toward closure while flow was still accelerating. Final closure of the valve was achieved at the time of zero flow and preceded the aortic second sound by 4-10 msec. The echographically determined "valve orifice area" correlated well with aortic stroke volume (r = 0.94). The intensity of the aortic first sound was related to peak acceleration of aortic flow. The intensity of the second sound was not related to the amplitude of cusp motion but correlated well with the aortic pressure at the time of closure and with peak flow deceleration.