Healthy 4D Flow MRI E/A Values
Published E/A velocity, E/A flow and E/A kinetic energy values from healthy volunteers. Select a parameter to inspect age placement, analysis method and study spread.
Descriptive values, not a diagnostic interval4D flow E/A by age
Values behind the plot
| Study | Measure / chamber | Age on chart | n | E/A | Spread |
|---|
Ratios are reported participant-level summaries. The E/A ratio of group E and A medians does not reproduce the median participant ratio.
Sequence parameters
Only studies used in the plot. Voxel sizes refer to the 4D flow sequence. Alattar reports a reconstructed voxel size after zero filling; the acquired voxel size is N/A. Varga-Szemes reports acquired voxel sizes.
| Study | 4D flow scanner / gating | Voxel size | Temporal resolution | Reconstructed cardiac phases |
|---|---|---|---|---|
| Alattar 2022, E/A velocity and flow | 3 T GE; retrospective ECG gating | 1 × 1.48 × 2.38 mm³ (reconstructed; acquired size N/A) | 34 ms | 50 |
| Varga-Szemes 2023, E/A velocity (conventional / compressed sensing) | 3 T Siemens Prisma; retrospective ECG gating | 2.4 × 3.5 × 3.8 / 2.4 × 3.5 × 3.6 mm³ (acquired) | 38.64 / 40.48 ms | 20 / 18–20 |
| Zhao 2023, LV and RV E/A kinetic energy | 3 T Philips, retrospective ECG; 1.5 T Siemens, prospective ECG | 3.0 × 3.0 × 3.0 mm³, both scanners | N/A (Table S1 does not specify a numeric value) | Philips 30; Siemens median 23 (IQR 20–24) |
| Crandon 2018 / Barker 2020, LV and RV E/A kinetic energy | 1.5 T Philips Ingenia; retrospective ECG | Approximately 3 × 3 × 3 mm³ | 40 ms | 30 |
Next candidate papers
Further work on diastolic filling and the interpretation of E/A measures:
- Lee et al., 2025 (SCMR abstract): In 39 healthy adults aged 18–82, valve-tracked mitral E/A flow rate decreased with age, with sex-related differences in E- and A-wave filling rates. The abstract does not provide age-group E/A values for plotting.
- in de Braekt et al., 2026: Repeated whole-heart 4D flow in 21 healthy volunteers assessed scan–rescan reproducibility of mitral E- and A-wave velocities and E/A. Repeated scans represent the same cohort.
- Stipechi et al., 2026: In 60 healthy volunteers, 4D flow mitral velocity and filling rate indices captured age-related LV filling changes; peak early filling rate correlated strongly with age.
- LV early and late filling, 2022: In 50 healthy volunteers, leaflet-tip and annulus-tracking E/A flow ratios aligned closely with echo and showed strong associations with age and LV remodeling.
- Zhao et al., 2021: In 74 healthy Asian volunteers, LV peak KE E/A decreased with age, while age- and sex-matched Asian and Caucasian 4D flow parameters were broadly similar. The study also compared age- and sex-matched Asian and Caucasian groups.
- Viola et al., 2024: In 97 people with chronic ischemic heart disease, a deep learning LV velocity E/A method correlated with echo E/A (R² = 0.72) and ran in about 40 seconds. The automated method showed the strongest echo association among the three approaches.
- Park et al., 2026: Measured E/A velocity, flow, vorticity and vortex volume across lean, overweight and T2D groups. E/A vorticity distinguished T2D-specific changes beyond overweight and correlated strongly with LV vortex volume (age- and sex-adjusted ρ = 0.82), as well as with echo mitral E/A (adjusted ρ = 0.35).
The Crandon LV and Barker RV results come from the same 53-person cohort. Zhao 2021 partly overlaps Zhao 2023, so these reports are not independent samples for pooling.
What the ratios mean. E/A velocity compares peak early and atrial filling speed at the mitral valve. E/A flow compares the corresponding peak volume flow rates across that plane. E/A kinetic energy compares the ventricular blood-flow energy peaks during E and A filling. E/A vorticity compares integrated LV rotational flow at those peaks, while E/A vortex volume compares the volume occupied by coherent vortical structures. Each is dimensionless, but values from different definitions should be interpreted separately.
Primary sources
- Zhao et al., JCMR 2023, Table 2.
- Crandon et al., Scientific Reports 2018, LV Table 2 and Methods.
- Barker et al., Scientific Reports 2020, RV Table 4 and Methods.
- Alattar et al., Diagnostic and Interventional Imaging 2022, Table 2 and Methods.
- Varga-Szemes et al., JMRI 2023, Table 1 and Results.
- Lee et al., JCMR 2025 conference abstract.
- in de Braekt et al., Applied Sciences 2026.
Study values are descriptive. No pooled estimate or clinical normal range was calculated.