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Assessment of Severity of Mitral Stenosis by Echocardiographic Leaflet Separation
Michael L. Fisher, MD;
Alfred F. Parisi, MD;
Gary D. Plotnick, MD;
Charles E. DeFelice, MD;
Nathan H. Carliner, MD;
Nicholas J. Fortuin, MD
Arch Intern Med. 1979;139(4):402-406.
Abstract
Mitral valve area (MVA) determined at cardiac catheterization was compared with M mode echocardiographic measurements in 44 patients with mitral stenosis and no substantial mitral regurgitation. Despite statistically significant correlations, measurements of anterior leaflet motion, including rate of diastolic closure (EF slope) were not useful in predicting severity of stenosis. In contrast, maximal diastolic separation of anterior and posterior leaflets (SEP) was more closely correlated with MVA and appears to have some predictive value. Narrow separation was associated with severe mitral stenosis. Wide separation was associated with relatively mild stenosis. Intermediate values in 16 of 44 patients (36%) were not of predictive value. Recognizing this limitation, measurement of maximal diastolic mitral leaflet separation from M mode echocardiograms is proposed as a simple and useful method for assessing severity of mitral stenosis.
(Arch Intern Med 139:402-406, 1979)
Author Affiliations
From the Medical Services, Veterans Administration hospitals, Baltimore and West Roxbury, Mass, and the Department of Medicine, University of Maryland School of Medicine (Drs Fisher, Plotnick, DeFelice, and Carliner), Harvard Medical School (Dr Parisi), and Johns Hopkins Medical Institutions (Dr Fortuin).
Footnotes
Accepted for publication Aug 25, 1978.
Reprint requests to Cardiology Section, Veterans Administration Medical Center (151), 3900 Loch Raven Blvd, Baltimore, MD 21218 (Dr Fisher).
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