Echocardiography Exam 2 Practice Test 2026 - Free Practice Questions and Study Guide

The key idea is that the mitral annulus early diastolic velocity, known as e′, directly reflects how quickly the ventricle relaxes in early diastole. Because e′ measures active myocardial relaxation and is relatively less influenced by filling pressures than the transmitral E velocity, it’s the most useful Tissue Doppler parameter for assessing LV relaxation. Taking the average of the mitral annulus e′ from both the lateral and septal sites gives a robust estimate of overall relaxation. When this average e′ is 8 cm/s or lower, it indicates impaired relaxation and diastolic dysfunction.

S′ is a systolic velocity, not relaxation, so it doesn’t assess diastolic relaxation. A′ at the septal annulus reflects atrial contraction more than intrinsic relaxation. Aortic annulus e′ isn’t used to gauge LV diastolic relaxation.