Annulus reversus is a sign on Doppler imaging used to support the diagnosis of constrictive physiology. Which statement best defines it?

Annulus reversus is a sign on Doppler imaging used to support the diagnosis of constrictive physiology. Which statement best defines it?

• A. Annulus reversus refers to medial (septal) e′ velocity exceeding lateral e′ velocity.
• B. Annulus reversus refers to lateral e′ velocity exceeding medial e′ velocity.
• C. Annulus reversus is not a reliable sign in constriction.
• D. Annulus reversus is diagnosed on M-mode imaging only.

Answer: (A)

Annulus reversus is a Doppler tissue imaging finding seen in constrictive physiology, defined by the septal (medial) e′ velocity exceeding the lateral e′ velocity. In constriction, the pericardium limits the lateral wall’s movement more than the septum, so the lateral e′ is reduced while the septal e′ remains relatively preserved or less affected. This reversal of the normal pattern (where lateral e′ is typically higher) supports the diagnosis of constrictive physiology. It is not an M-mode finding and is not a statement about reliability on its own, though it adds useful evidence when interpreted with other findings.

Annulus reversus is a Doppler tissue imaging finding seen in constrictive physiology, defined by the septal (medial) e′ velocity exceeding the lateral e′ velocity. In constriction, the pericardium limits the lateral wall’s movement more than the septum, so the lateral e′ is reduced while the septal e′ remains relatively preserved or less affected. This reversal of the normal pattern (where lateral e′ is typically higher) supports the diagnosis of constrictive physiology. It is not an M-mode finding and is not a statement about reliability on its own, though it adds useful evidence when interpreted with other findings.