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Mitral inflow is dependent on the rate of ventricular relaxation, left atrial pressure, relative compliance of atrial and ventricular chambers as well as the ventricular suction effect. Limitations of mitral inflow velocity in left ventricular diastolic function assessmentĮven though the most widely used measure of left ventricular diastolic dysfunction is documentation of E/A reversal in mitral inflow velocity by Doppler echocardiography, it has several limitations. MV E Vel: early mitral inflow velocity MV DecT: deceleration time of the early mitral inflow velocity MV Dec Slope: deceleration slope of mitral inflow velocity MV A Vel: mitral inflow velocity during atrial systole MV E/A Ratio: ratio between early mitral inflow velocity and atrial systolic mitral inflow velocity. Mitral E/A reversal on echocardiographyĬonventional Doppler assessment of transmitral flow showing E/E reversal in left ventricular diastolic dysfunction. This is because the blood flow velocities are much higher than the velocity of tissue movement with systole and diastole.
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It may be noted that the Nyquist limit for the colour tissue Doppler is 0.16 meters per second in this image while it is 0.65 meters per second in the image below for colour Doppler imaging (colour flow mapping). In this case the ratio is given as 13.7, suggesting diastolic dysfunction.
#DOPPLER MAX 6 SOFTWARE#
The software usually gives the E/E’ ratio. The cursor is placed over the medial mitral annulus and tissue Doppler tracing obtained. After that colour Tissue Doppler (tissue velocity imaging or TVI) mode is switched on to assess tissue Doppler. Initially mitral E wave is measured and stored as given in the image below. Tissue Doppler echocardiography showing measurement of mitral E/E’ ratio for assessment of diastolic dysfunction. Mitral E/E’ ratio on echocardiogram (Doppler echocardiography) It can be used in the presence of atrial fibrillation when E/A ratio is not available.
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Abstract: Mitral E/E’ ratio on echocardiogram is an important indicator of left ventricular diastolic function.