M-mode and Cross-sectional Echocardiographic Evaluation of Rheumatic Mitral Valve Disease : SYMPOSIUM ON CURRENT TOPICS AND FUTURE PROSPECTS IN ECHOCARDIOGRAPHY

M-mode and cross-sectional echocardiograms were obtained in 30 patients with rheumatic mitral valve disease (24 : MS, 6 : MR) pre and post-operatively for the evaluation of their severity. Echocardiographic findings were compared with operative findings. Mitral valve area (MVA), E-F slope (DDR) and mean circumferential fiber lengthening during rapid filling course (mVcF(RF)) were measured in patients with MS (1.2 cm2, 14mm/sec 1.3 circ/sec respectively) and they were significantly improved after operation (2.2 cm2, 35mm/sec, 19 circ/sec respectively). Assessment of fusion of both commissures could be detected in 8 of 13 cases (62%) who underwent papillotomy in addition to commissurotomy. In patients with MR, short axis images of cross-sectional echocardiogram showed mitral incompetence during systole with marked enlargement of left atrium and mitral annulus (63 mm, 46 mm respectively). It was suggested that M-mode echocardiogram was more useful to estimate the axial dimensions and the cardiac cycle and was sensitive to detect rheumatic mitral valve disease, but it was of limited valve for the assessment of its severity. On the other hand, cross-sectional echocardiogram was proved to be valuable for the assessment of the whole mitral complex, which was useful not only for the evaluation of the severity of mitral valve disease but for the assignment of operative category.