Cross-Sectional Echocardiographic Observation of Mitral Leaflets and Subvalvular Structures in Mitral Stenosis

High-speed cross-sectional echocardiography was performed along the long axis of the left ventricle in 24 patients with mitral stenosis. The anterior mitral leaflet (AML) showed two different echo patterns. In 22 patients, the AML had no particularly intensive echo in any parts or only a moderately increased echo at the tip. Two patients showed an extremely strong echo in a part or whole of the AML. The posterior mitral leaflet (PML) was variable in echo-intensity and showed an abnormal position. A comparison between early-diastolic mitral domes in cross-sectional echocardiogram and angiocardiogram in 12 patients, using the A- and E-angles, showed a good correlation coefficient of r= 0.85 (P < 0.001). Moreover, the dome angle in cross-sectional images was related to the left atrial dimension measured by the method of Hirata and associates on patients without the severely affected AML. Two-dimensional echocardiogram in 15 patients through leaflets, papillary muscles and chordae tendineae disclosed three different patterns : (a) column-like complex, (b) discrete chordae tendineae and (c) intermediate form. In two patients, the anterior and posterior papillary muscles showed different patterns from one other.