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Case Reports
. 2014 May-Jun;66(3):392-3.
doi: 10.1016/j.ihj.2014.03.022. Epub 2014 Apr 19.

L wave in echo Doppler

Vipin Kumar  1 , John Jose  2 , V Jacob Jose  3
Affiliations
Case Reports

L wave in echo Doppler

Vipin Kumar et al. Indian Heart J. 2014 May-Jun.

Abstract

62-year-old female presented with progressive dyspnea NYHA class III for six months. Echocardiography showed normal left ventricular (LV) systolic function, mild biatrial enlargement, an L wave in pulse wave Doppler at mitral inflow and in M mode echocardiography across mitral valve. Tissue Doppler imaging at medial mitral annulus showed an L' wave in mid diastole in addition to E' and A' wave. An L wave in pulse wave Doppler and M mode echocardiography represents continued pulmonary vein mid diastolic flow through the left atrium in to LV across mitral valve after early rapid filling. Presence of an L' wave in these patients associated with higher E/E' is indicative of advance diastolic dysfunction with elevated filling pressures.

Keywords: L wave; Left ventricular diastolic dysfunction; L′ wave; Triphasic mitral inflow.

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Figures

Fig. 1
Fig. 1
(A) – Mitral Doppler inflow showing early (E) and late (A) mitral inflow waves with an L wave between the E and A wave; (B) – E/A ratio >2; (C) – M mode echocardiography across mitral valve with E, A and an L wave; (D) – Medial mitral annulus velocity pattern showing E′, A′ and an L′ wave. (E – peak velocity of mitral inflow during early filling phase; E′ – early diastolic mitral annular velocity; A – peak velocity of mitral inflow during atrial contraction; A′ – late diastolic mitral annular velocity; L′ – mid diastolic mitral annular velocity.)
See this image and copyright information in PMC

References

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