Circulation, Vol 55, 120-128, Copyright © 1977 by American Heart Association
PM Nichol, BW Gilbert and JA Kisslo
A real-time, phased-array, two-dimensional echocardiography system was used
to assess mitral valve motion in 30 catheterized patients with pure mitral
stenosis. Suitable images for analysis of mitral valve motion were obtained
in 25 patients. The valve leaflets were most thickened and immobile at the
leaflet tips while maximum mobility was at the leaflet body. Diastolic
movement of anterior mitral leaflet toward the septum pulled the posterior
mitral leaflet mid-portion inferiorly. Systolic bulging of the mid-portion
of the anterior mitral leaflet into the left atrium was seen in 40% (10 of
25). Movement of the anterior mitral leaflet in diastole is primarily due
to movement of the whole mitral apparatus in patients with mitral stenosis.
The anterior mitral leaflet E to F slopes did not correlate (r=0.38) with
the mitral valve area determined at catheterization. Planimetry of the
mitral valve area directly from the videotape images compared favorably to
the valve area determined at catheterization (r=0.95). Thus, mitral valve
area determined by this technique is an accurate noninvasive method for
assessing the severity of mitral stenosis.
ARTICLES
Two-dimensional echocardiographic assessment of mitral stenosis
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