Mitral inflow E velocity sampling
Read more:ASE 2019 · Comprehensive TTE examination
Quick reference:↑ Diastolic function and filling pressures
| View | Apical four-chamber, pulsed-wave Doppler. |
|---|---|
| Timing | Early diastole (E) and atrial contraction (A); check for E–A fusion at higher heart rates. |
| Caliper / trace | 1–3 mm sample volume at the tips of the open mitral leaflets, placed toward the lateral wall; peak E, peak A and E deceleration time measured on the modal signal. |
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Correct example
Small gate at the leaflet tips oriented toward the lateral wall where inflow is directed, clear E and A peaks and a traceable deceleration slope.
Common error
Sampling at the annulus (lower velocities) or deep in the ventricle, or measuring deceleration time and E/A when the A wave begins on the E deceleration slope above 20 cm/s (significant fusion).
Effect on interpretation
E feeds E/e′ and E/A; with fusion the E/A ratio is decreased and A increased, so grading from fused signals misclassifies filling pattern.
Why
The leaflet-tip position records the highest inflow velocity; the annulus is reserved for volumetric flow, not for the E velocity used in diastolic indices.