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Figure 1 Superimposed aortic and mitral Doppler recordings. (Top) Total isovolumic time (t-IVT) normally falls with stress. (Middle) In left bundle branch block (LBBB), the total filling time is short and t-IVT is prolonged at rest. In the absence of coronary artery disease (CAD), t-IVT falls with stress, but does not change in patients with CAD (bottom), so that one-third of the cardiac cycle is neither ejecting nor filling. A2 = the aortic component of the second heart sound; ECG = electrocardiogram; PCG = phonocardiogram.
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