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Figure 2 Pulsed-wave Doppler recording of mitral inflow velocity (top) demonstrating a mid-diastolic flow (arrow) due to markedly delayed myocardial relaxation. Tissue Doppler imaging (bottom) shows mid-diastolic velocity (arrow) from the septal mitral annulus. E = early diastolic velocity; A = late diastolic velocity due to atrial contraction; S = peak systolic velocity of the mitral annulus, S is also markedly reduced.