The deceleration time is prolonged in conditions leading to a delayed equalization of the pressure gradient. The deceleration time indicates the duration for equalizing the pressure difference between the left atrium and the left ventricle. The E-wave deceleration time is normally between 150 ms and 240 ms. Deceleration time (DT) is the time interval from the peak of the E-wave to its projected baseline (Figure 2). The normal E-wave displays a rapid acceleration (ascending part) and rapid deceleration (descending part). Normally, the peak E-wave velocity is between 0.6 and 0.8 m/s and it occurs approximately 100 ms after the start of the E-wave. Left ventricular compliance (i.e the ability of the ventricle to relax and stretch out during diastole).The pressure gradient between the left atrium and the left ventricle.The main factors determining E-wave velocity and form are the following: The amplitude and form of the E-wave reflect the velocity and course of the flow. Thus, the initial flow (ventricular filling) is propelled by the pressure gradient between the atrium and the ventricle. Ventricular pressure drops below atrial pressure, which results in the opening of the mitral valve and passive flow of blood from the atrium to the ventricle. The relaxation results in a rapid drop in ventricular pressure. This pressure gradient develops immediately after the aortic valve closes (which marks the start of diastole) and the left ventricle starts to relax.

This flow is propelled by the pressure gradient between the left atrium and the left ventricle. The E-wave represents passive blood flow from the left atrium to the left ventricle. As Figure 1B illustrates, the mitral inflow yields 3 phases on the spectral curve: E-wave, diastasis, and A-wave. The pulsed Doppler beam can be positioned using color Doppler (to visualize the direction of flow) and continuous Doppler (to locate the maximum flow velocities). Gain and filter should be minimized in order to obtain optimal images. The sample volume (SV) should be placed between the leaflet tips (1–3 mm axial length of SV) and sweep speed is set to 50 mm/s to 100 mm/s (Figure 1). E/A ratio: Blood flow across the mitral valveįlow velocity across the mitral valve is examined in the apical four-chamber view (A4C) using pulsed Doppler. These three methods, as well as several supplementary methods, will now be discussed in detail. Estimating left ventricular filling pressure via e'.ĭiastolic function can be estimated from E/A ratio, e' and deceleration time (DT).The E/A ratio is derived by measuring flow velocities across the mitral valve using pulsed Doppler. The ratio between E-wave and A-wave ( E/A ratio).The American Society for Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI) stress that the following parameters are of particular importance for the evaluation of diastolic function: Tissue Doppler is used to measuring mitral annular plane velocity.

Mitral flow velocities are measured using Pulsed Doppler. Blod flow velocities across the mitral valve and mitral annular plane velocity are standard assessments. Currently recommended methods evaluate left atrial and left ventricular function, geometry, and various Doppler parameters. Methods for evaluating left ventricular diastolic function have evolved considerably in the past two decades. Echocardiographic assessment of left ventricular diastolic function

Mitral regurgitation grade 1 2 3 4