Restrictive mitral inflow Doppler patterns in severe aortic regurgitation

The hemodynamic mechanism for the restrictive mitral inflow pattern on continuous wave Doppler is the same as for early closure of the mitral valve seen on the M-mode echocardiogram (ie, rapid increase in left ventricular diastolic pressure). The continuous wave Doppler in panel A shows an abnormally short deceleration time (147 ms), measured along the line joining point A and B (arrow), and short pressure half-time (PHT) of 43 ms, a result of a rapid and early rise in left ventricular diastolic pressure due to competition for filling of the ventricle between the normal inflow, represented by the mitral inflow signal, and the regurgitant flow represented by diastolic "noise" in the background. The continuous wave Doppler of mitral inflow in severe aortic regurgitation obtained from transesophageal echocardiogram is seen on panel B.