Changes in Mitral Annular Ascent with Worsening Echocardiographic Parameters of Left Ventricular Diastolic Function

Figure 1

Representative M-mode tracing showing maximal mitral annular plane systolic motion. MA ascent (MAa) was measured as the distance of the annulus traversed from the end of diastasis until the end of atrial contraction (white arrow) from the imaginary line drawn (dotted white line) that represents annular motion during diastasis with the sharp ascent (downward slope) towards the atria after atrial contraction. Please note that typically several lines are always seen when performing M-mode of the MA due to the contribution of chordal structures. However, since these images have the same frequency, their reflected images maintain the same distance. Usually, the most reflective echo-bright image should be used for the purpose of measurements as shown in this figure. MAPSE is also shown.