Centilo

Doppler Z-Scores

BSA-indexed z-scores for pulsed Doppler velocities, times, and VTI at the aortic valve, pulmonary valve, and aortic arch

For educational and informational purposes only. Verify all results before clinical application.

kg
cm

References

  1. Cantinotti M, Giordano R, Scalese M, et al. Nomograms of pulsed Doppler velocities, times, and velocity time integrals for semilunar valves and great arteries in healthy Caucasian children. Int J Cardiol. 2019;285:133-139.[DOI]

Reviewed by Daniel Diaz-Gil, MD · Last updated March 2026

Medical disclaimer

This tool is for educational and informational purposes only. It is not a substitute for professional clinical judgment. Always independently verify results before making clinical decisions.

Professional Resources — Tools used by pediatricians for cardiac assessment

Park's Pediatric Cardiology for Practitioners, 7th EdComprehensive reference for pediatric cardiology evaluation and management~$95via AmazonEchocardiography in Pediatric and Congenital Heart Disease, Lai et alDefinitive echo reference with z-score tables and imaging protocols~$180via AmazonBoardVitals Pediatric Cardiology QbankBoard-style questions for pediatric cardiology certificationsubscriptionvia BoardVitals
Clinical Reference & Evidence

Doppler Z-Scores for Semilunar Valves and Great Arteries

Overview

This calculator provides BSA-indexed z-scores for pulsed Doppler hemodynamic parameters measured at the aortic valve, pulmonary valve, and aortic arch in healthy children. It uses regression equations from the Cantinotti 2019 nomograms derived from 712 healthy Caucasian children aged 0-17 years.

What It Measures

  • Velocity time integrals (VTI) at the aortic, pulmonary, and arch levels
  • Doppler-derived stroke volume (SV) and cardiac output (CO)
  • Systolic acceleration and deceleration times (AT, DT)
  • Time ratios (AT/ET, DT/ET, VTI/ET, Max Vel/ET)
  • Maximal systolic velocities
  • Vessel diameters (sub-aortic, pulmonary, arch)

When to Use

  • Assessing hemodynamic significance of aortic or pulmonary stenosis
  • Evaluating cardiac output in children with heart failure or post-surgical physiology
  • Monitoring flow parameters after cardiac surgery or catheter interventions
  • Screening for hemodynamically significant shunts (Qp:Qs estimation)
  • Evaluating pulmonary hypertension (pulmonary acceleration time)

Interpretation

Z-Score Range Classification
-2 to +2 Normal
-3 to -2 or +2 to +3 Borderline
< -3 or > +3 Abnormal

Key Clinical Points

  • All parameters are indexed to BSA using the Haycock formula
  • Three regression model types are used depending on the parameter's relationship with BSA (exponential, linear, or cubic)
  • Stroke volume and cardiac output scale strongly with BSA (exponential model)
  • Time ratios (AT/ET, DT/ET) are relatively BSA-independent
  • Pulmonary acceleration time (PAAT) < 90 ms correlates with elevated pulmonary vascular resistance

Limitations

  • Derived from a single-center Caucasian Italian population
  • Some measurements had low R-squared values, limiting z-score precision for those parameters
  • Not validated for children with congenital heart disease or hemodynamic abnormalities
  • Doppler measurements are operator-dependent and angle-sensitive

Reference

Cantinotti M, Giordano R, Scalese M, et al. Nomograms of pulsed Doppler velocities, times, and velocity time integrals for semilunar valves and great arteries in healthy Caucasian children. Int J Cardiol. 2019;285:133-139. DOI: 10.1016/j.ijcard.2019.03.001