Left ventricular filling pressures in hypertrophic cardiomyopathy measured by tissue Doppler echocardiography

The left ventricular filling pressures can be estimated using transmitral velocity (panel A), mitral annular velocity (panel B), and the flow propagation velocity (panel C), which is the slope of the linear component of the color border produced by the propagation of early filling peak velocity (E) into the left ventricle, past the mitral valve. In this patient, the early diastolic peak filling velocity across the mitral valve (E) is about 100 cm/sec and lower than late diastolic peak filling velocity (panel A). The early diastolic peak filling velocity across the mitral annulus (Ea) is 6 cm/sec and is also lower than the late peak filling velocity (Aa). The ratio of E/Ea (16.7) correlates with the left ventricular filling pressure (Pre A) of 24 mmHg obtained at the time of cardiac catheterization (panel D). EDP indicates LVEDP; Pre-A, left ventricular filling pressure prior to atrial contraction.