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154  Section 3  Cardiovascular Disease

                                                             Figure 16.23  Doppler evaluation of diastolic mitral (a–c,e) and
                                    (b)
             (a)
  VetBooks.ir                                                and cranial four‐chamber views, respectively, using color flow (a,d)
                                                             tricuspid (d) inflows in a normal dog, from the left parasternal apical
                                                             and pulsed‐wave (b,c,e) Doppler modes. Both flows are coded in
                                                             red, as they go toward the transducer during diastole (a,d). For
                                                             mitral inflow analysis using the pulsed‐wave Doppler mode, the
                                                             sample gate is placed at the tip of the mitral leaflets (b). The
                                                             transmitral inflow pattern (c) is hollow (as the mitral inflow is
                                                             laminar) and typically biphasic, including an early rapid positive
                                                             filling wave (E) and a late positive filling wave (A) of lower velocity
                                                             resulting from atrial contraction. The calculation of isovolumic
                                                             relaxation time (IVRT) is shown in (e): IVRT represents the time
             (c)                     (d)                     between aortic valve closure (1) and mitral valve opening (2) and is
                                                             an index of diastolic function. LA, left atrium; LV, left ventricle; RA,
                                                             right atrium; RV, right ventricle.










                  (e)














                                                             Figure 16.24  Aliasing artifact associated with the pulsed‐wave
                                                             Doppler mode. When blood flow velocities exceed the Nyquist limit
                                                             (here 0.4 m/s for the pulmonary flow), the aliasing artifact occurs:
                                                             the flow profile wraps around the image and becomes inverted (in
                                                             this example positive instead of negative, arrows). The deeper the
                                                             recorded blood flow, the lower the Nyquist limit.
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