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Fig. 2 Images in 10% step reconstructions of R-R interval in
parallel short-axis plane show dynamic morphology of mitral valve throughout
one cardiac cycle. Because of space limitations, only every second image of 5%
step reconstructions is shown. Image at 5% on level of commissures (large
white arrows) demarcates zone of apposition, where anterior meets
posterior leaflet during systole. Images at 15% and 25% show opening of
leaflets with reversion of curvature (25%, black arrowhead), while
edges stay approximated (large white arrows). During early diastole
(35%), leaflets open rapidly (black arrows). After reaching maximal
opening (45%, black arrows), leaflet opening is minimally reduced
(55%, black arrows) until second opening impulse occurs (65%,
black arrows). Some tendinous cords and anterolateral papillary
muscle belly (small white arrows, 55% and 65%) can be depicted on
these images. At 75% and 85%, rapid closure can be visualized with bulging of
leaflets (black arrows) until reaching each other at late diastole
(95%). Note good image quality of leaflets and zone of apposition during valve
closure and maximal opening and inferior image quality of leaflets in
transitional phases. Because of additional movements of valve plane toward
atrium and ventricular apex, images chosen to visualize leaflets are located
more cranially during diastole and more caudally during systole.