In mitral stenosis, a classic M-mode finding is flattening of the E-F slope. what causes this flattening?
In M-mode imaging, the E-F slope of the anterior leaflet represents the rate of early diastolic filling of the left ventricle. Normally, the left atrium empties rapidly. In mitral stenosis, however , the filling time is prolonged, and this slow filling is reflected by the descent of the anterior leaflet. Attempts to quantify the degree of mitral stenosis on the basis of the E-F slope have not proved sensitive nor specific. The slope is affected by the severity of leaflet fibrosis, as well as left ventricle compliance, , the heart rate, and the motion of the mitral annulus during diastole.