The assumption that the summit of the left atrial 'v' wave marks the opening of the mitral valve is challenged by observations that it may occur earlier.
Blood flowing into the left atrium during ventricular systole causes an increase in pressure known as the "v" wave. From the apex of the "v" wave pressure declines in the "y" descent. Diagnostic formulk have been based upon the assumption that the summit of the "v" wave marks the opening of the mitral valve and the whole of the "y" descent represents atrial emptying. This hypothesis is not consistent with the observation that the "v" peak may occur earlier, even before the aortic valve has closed (Luisada and Liu, 1959; Rich, 1959).
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P.G.F. Nixon (1961) studied this question.
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