Mitral stenosis, aortic stenosis, and impaired relaxation of the LV will cause which Doppler change?

Mitral stenosis, aortic stenosis, and impaired relaxation of the LV will cause which Doppler change?

• A. Shortened decel time
• B. No change
• C. Variable
• D. Prolonged decel time

Answer: (D)

Deceleration time of the early filling E wave reflects how quickly the ventricle can accept blood in early diastole, i.e., LV relaxation and compliance. When relaxation is slow or the ventricle is stiff, the rise and subsequent deceleration of early diastolic flow are gradual, prolonging the time from peak velocity to baseline. Mitral stenosis narrows the mitral valve and slows the transfer of blood into the LV, so the early filling phase decelerates more slowly, lengthening the deceleration time. Aortic stenosis often leads to LV hypertrophy and diastolic dysfunction, making the LV relax more poorly and further prolonging the deceleration of the E wave. Impaired LV relaxation by itself clearly extends the DT as well. In contrast, a very short deceleration time would suggest a restrictive filling pattern with high filling pressures, which is not the scenario described here.

Deceleration time of the early filling E wave reflects how quickly the ventricle can accept blood in early diastole, i.e., LV relaxation and compliance. When relaxation is slow or the ventricle is stiff, the rise and subsequent deceleration of early diastolic flow are gradual, prolonging the time from peak velocity to baseline.

Mitral stenosis narrows the mitral valve and slows the transfer of blood into the LV, so the early filling phase decelerates more slowly, lengthening the deceleration time. Aortic stenosis often leads to LV hypertrophy and diastolic dysfunction, making the LV relax more poorly and further prolonging the deceleration of the E wave. Impaired LV relaxation by itself clearly extends the DT as well.

In contrast, a very short deceleration time would suggest a restrictive filling pattern with high filling pressures, which is not the scenario described here.