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British Heart Journal May 1981Digitised left ventricular echocardiograms were studied in nine children with congenital mitral stenosis to assess the severity of inflow obstruction. In six children...
Digitised left ventricular echocardiograms were studied in nine children with congenital mitral stenosis to assess the severity of inflow obstruction. In six children the two prime indices of mitral stenosis were abnormal, with a prolonged time from minimum dimension to 20 per cent dimension change and a reduced peak dimension change during diastole. In three, however, these values did not suggest inflow obstruction, depsite significant gradients at cardiac catheterisation. Two-dimensional echocardiography was performed in 10 children with congenital mitral stenosis to determine the mitral annular size and the morphology of the valve and subvalvular apparatus. The annular size and number of papillary muscles could be assessed along with the detection of combined mitral abnormalities. Two-dimensional studies can reliably delineate the type of mitral abnormality, and should be performed in all cases with congenital heart disease having a high incidence of associated left ventricular inflow obstruction. Digitised M-mode left ventricular echocardiography is in general unreliable in assessing congenital obstruction, though it may be of some value in individual cases.
Topics: Adolescent; Child; Child, Preschool; Echocardiography; Heart Ventricles; Humans; Infant; Mitral Valve; Mitral Valve Stenosis
PubMed: 7236458
DOI: 10.1136/hrt.45.5.527 -
The Israel Medical Association Journal... Jan 2003With the introduction of surgery and percutaneous balloon valvuloplasty for relieving severe mitral stenosis the natural history of the disease has markedly altered.
BACKGROUND
With the introduction of surgery and percutaneous balloon valvuloplasty for relieving severe mitral stenosis the natural history of the disease has markedly altered.
OBJECTIVES
To determine the natural history of the disease in patients with moderate mitral valve stenosis.
METHODS
Demographic, clinical and echocardiographic data were evaluated in 36 patients with moderate mitral stenosis during a follow-up of 71 +/- 15 months.
RESULTS
The 36 patients comprised 32 women and 4 men with a mean age of 43.7 +/- 12.2 years; 28 were Jewish and 8 were of Arab origin. During follow-up, there was a significant decrease in mitral valve area, with an increase in mean mitral valve gradient and score. Mean loss of mitral valve area was 0.04 +/- 0.11 cm 2/year. No correlation was found between disease progression and age, past mitral valve commissurotomy, baseline mean gradient or mitral valve score. Larger baseline mitral valve area (P = 0.007) and Arab origin (P = 0.03) had an independent correlation to loss of mitral valve area. Fifteen patients (42%) did not demonstrate any loss in mitral valve area during the follow-up period.
CONCLUSIONS
The rate of mitral valve narrowing in patients with moderate mitral stenosis is variable and cannot be predicted by patient's age, past commissurotomy, valve score or gradient. Secondly, larger baseline mitral valve area and Arab origin showed an independent correlation to loss of mitral valve area; and finally, in many patients valve area did not change over a long observation period.
Topics: Adult; Age Factors; Aged; Disease Progression; Echocardiography, Doppler; Female; Follow-Up Studies; Hemodynamics; Humans; Male; Middle Aged; Mitral Valve Stenosis
PubMed: 12592951
DOI: No ID Found -
Asian Journal of Surgery Oct 2023
Topics: Humans; Mitral Valve Stenosis; Thrombosis; Heart Atria
PubMed: 37183113
DOI: 10.1016/j.asjsur.2023.05.023 -
Journal of the American College of... Feb 2015
Topics: Exercise Test; Female; Humans; Male; Mitral Valve Annuloplasty; Mitral Valve Insufficiency; Mitral Valve Stenosis; Ultrasonography
PubMed: 25660924
DOI: 10.1016/j.jacc.2014.10.068 -
Journal of the American College of... Jun 1991Doppler echocardiography was used to determine changes in transmitral gradient and pulmonary artery pressure after exercise in 12 patients with mitral stenosis and 11... (Comparative Study)
Comparative Study
Effects of exercise on transmitral gradient and pulmonary artery pressure in patients with mitral stenosis or a prosthetic mitral valve: a Doppler echocardiographic study.
Doppler echocardiography was used to determine changes in transmitral gradient and pulmonary artery pressure after exercise in 12 patients with mitral stenosis and 11 patients with a prosthetic mitral valve. The mean transmitral gradient in the mitral stenosis group was 9 +/- 7 mm Hg at rest and increased to 17 +/- 8 mm Hg after exercise. In patients with a prosthetic mitral valve, exercise resulted in an increase in mean transmitral gradient from 5 +/- 2 to 8 +/- 3 mm Hg. Calculated pulmonary artery systolic pressure increased with exercise from 41 +/- 19 to 70 +/- 32 mm Hg in the mitral stenosis group and from 28 +/- 8 to 39 +/- 15 mm Hg in patients with a prosthetic valve. Exercise Doppler echocardiographic evaluation of changes in transmitral gradient and pulmonary artery systolic pressure was found to be technically simple and an important addition to the noninvasive evaluation of patients with mitral valve disease.
Topics: Adult; Echocardiography, Doppler; Evaluation Studies as Topic; Exercise; Exercise Test; Female; Heart Valve Prosthesis; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Stenosis; Pulmonary Wedge Pressure
PubMed: 2033184
DOI: 10.1016/0735-1097(91)90641-l -
Journal of the American College of... Mar 1983Two-dimensional echocardiograms of the mitral valve orifice area were obtained in 50 normal pediatric subjects, 15 patients with congenital mitral stenosis and 7...
Two-dimensional echocardiograms of the mitral valve orifice area were obtained in 50 normal pediatric subjects, 15 patients with congenital mitral stenosis and 7 patients with tricuspid atresia. The mitral area was measured near the tips of the mitral valve leaflets from a diastolic cross-sectional image of the left ventricle. The cardiac images were recorded on videotape and later transferred to video disc for high resolution contour tracing. Contour analysis was performed by a special purpose microcomputer system for calculation of the enclosed calibrated area. In normal patients, there was an excellent correlation (r = 0.95) between mitral valve area (MVA) (in cm2) and body surface area (BSA) (in m2) described by MVA = 4.83 X BSA - 0.07. Each patient with mitral stenosis had a mitral valve area that measured less than the third percentile predicted from the normal regression formula. In eight patients in whom the Gorlin formula could be applied, there was excellent correlation (r = 0.95) between echocardiographic and hemodynamic measurements of mitral valve area. Each patient with tricuspid atresia had a very large mitral valve area (greater than 99th percentile of normal). It is concluded that noninvasive measurement of mitral valve orifice area can be accurately achieved by two-dimensional echocardiography in pediatric patients with congenital mitral stenosis, allowing serial measurement of their mitral valve area.
Topics: Child; Child, Preschool; Echocardiography; Humans; Infant; Mitral Valve; Mitral Valve Stenosis; Reference Values; Tricuspid Valve
PubMed: 6826975
DOI: 10.1016/s0735-1097(83)80202-2 -
Interactive Cardiovascular and Thoracic... Jan 2012Accessory mitral valve tissue (AMVT) is a rare congenital anomaly of endocardial cushion. Usually, it arises from the anterior mitral leaflet and causes the left...
Accessory mitral valve tissue (AMVT) is a rare congenital anomaly of endocardial cushion. Usually, it arises from the anterior mitral leaflet and causes the left ventricular outflow tract obstruction. We report here the first and a rarest presentation of the AMVT in a 19-year old female patient diagnosed to have double outlet right ventricle, ventricular septal defect (VSD), infundibular stenosis and congenital mitral stenosis (MS). She presented with a history of shortness of breath and chest pain over 3 years. Diagnosis was made by chest X-ray, transthoracic and transoesophageal echocardiography, which was confirmed by cardiac catheterization, and angiography. A successful closure of the VSD with excision of the right ventricular bundle and excision of the AMVT was done. Post-operative course was uneventful and an echocardiogram before the discharge showed no residual shunt, no right ventricular outflow gradient or mitral regurgitation, and the gradient across the mitral valve was 5/3 mmHg. We emphasize that, although AMVT commonly produces left ventricular outflow tract obstruction, it should be considered a rare but an important cause of congenital MS.
Topics: Cardiac Surgical Procedures; Diagnosis, Differential; Echocardiography; Female; Humans; Mitral Valve; Mitral Valve Stenosis; Young Adult
PubMed: 22108926
DOI: 10.1093/icvts/ivr011 -
Turk Kardiyoloji Dernegi Arsivi : Turk... Jan 2019The aim of this study was to examine the role of isolated rheumatic mitral stenosis (MS) in remodeling of the aorta at various locations.
OBJECTIVE
The aim of this study was to examine the role of isolated rheumatic mitral stenosis (MS) in remodeling of the aorta at various locations.
METHODS
In this prospective study, patients who were to undergo transesophageal echocardiography for various indications were screened. The study participants were classified into 2 groups according to the presence of MS with a valve area ≤1.5 cm2. Factors associated with the index dimensions of the aorta at the levels of the annulus, root, sinotubular junction (STJ), and the proximal ascending portion (5 cm from the annulus) were evaluated. Multivariate linear models were constructed including factors that affect the size of the aorta at any of the aforementioned levels. Pearson's correlation coefficient was used to investigate the association between mitral valve area, mitral valve gradient, and dimensions of the aorta.
RESULTS
A total of 179 men and 354 women were enrolled. Eighty-four patients had MS (15.8%). The patients with MS were younger and less likely to have hypertension. In univariate analysis, patients with MS had a smaller annulus and STJ (p=0.003 and p=0.043, respectively). Multivariate analysis indicated that MS was correlated with a smaller indexed size of the aortic annulus, yielding a regression coefficient value of 0.541 (p=0.005).
CONCLUSION
The presence of significant stenosis at the level of the mitral valve is associated with a smaller diameter in the aortic annulus. It is yet to be clarified whether this phenomenon occurs due to chronic, long-standing, low stroke volume or involvement of the aortic annulus in the fibrotic process of mitral disease.
Topics: Adult; Aged; Aorta; Echocardiography, Transesophageal; Female; Humans; Male; Middle Aged; Mitral Valve Stenosis; Prospective Studies
PubMed: 30628900
DOI: 10.5543/tkda.2018.04900 -
Journal of the American College of... Nov 1996This study sought to compare the mitral valve areas of patients with rheumatic mitral valve stenoses as determined by means of four echocardiographic and Doppler methods... (Comparative Study)
Comparative Study
OBJECTIVES
This study sought to compare the mitral valve areas of patients with rheumatic mitral valve stenoses as determined by means of four echocardiographic and Doppler methods with those obtained by direct anatomic measurements.
BACKGROUND
There has been no systemic comparison between Doppler-determined valve areas and the true anatomic orifice in a single cohort.
METHODS
In 30 patients with mitral stenosis, the mitral valve areas determined by two-dimensional echocardiographic planimetry, pressure half-time, flow convergence region and flow area were compared with the values directly measured on the corresponding excised specimen by means of a custom-built sizer.
RESULTS
The correlation coefficient was r = 0.95 (SE 0.06, p < 0.0001) for two-dimensional planimetry; r = 0.80 (SE 0.09, p < 0.0001) for pressure half-time; r = 0.87 (SE 0.09, p < 0.0001) for flow convergence region; and r = 0.54 (SD 0.1, p < 0.002) for flow area. Two-dimensional echocardiographic planimetry, pressure half-time, flow convergence region and flow area overestimated the actual anatomic orifice by > 0.3 cm2 in 2, 1, 6 and 0 patients, respectively, and underestimated it by > 0.3 cm2 in 0, 4, 1 and 8 patients, respectively.
CONCLUSIONS
Mitral valve areas determined by two-dimensional planimetry, pressure half-time and proximal flow convergence region reliably correlated with size of the anatomic orifice. The flow area method provided a less reliable correlation.
Topics: Adult; Aged; Echocardiography; Female; Humans; Male; Middle Aged; Mitral Valve; Mitral Valve Stenosis; Rheumatic Heart Disease
PubMed: 8890815
DOI: 10.1016/S0735-1097(96)00326-9 -
Brazilian Journal of Cardiovascular... Aug 2020To examine the relationship between the left atrial (LA) thrombus presence and the epicardial adipose tissue (EAT) thickness.
OBJECTIVE
To examine the relationship between the left atrial (LA) thrombus presence and the epicardial adipose tissue (EAT) thickness.
METHODS
Three hundred and twelve consecutive rheumatic mitral valve stenosis (RMVS) patients with mitral valve area (MVA) < 2 cm2 were included in this cross-sectional study. Patients were divided into two groups, those with and those without LA thrombus. Routine biochemical analysis and electrocardiographic examinations were carried out. EAT was measured using transthoracic echocardiography.
RESULTS
LA thrombus was determined in 84 (26.9%) RMVS patients. In echocardiographic examinations, higher mean gradient and LA diameter as well as lower MVA were found in the group with LA thrombus (P<0.001). In this group, higher C-reactive protein (CRP) and EAT values were also determined (P<0.001). There was significant correlation between EAT and MVA, CRP, LA appendage peak flow velocity, LA anteroposterior diameter, and mean gradient (P<0.001). Higher EAT values were identified as independently associated with the presence of LA thrombus (odds ratio 59.5; 95% confidence interval 12.1-290.10; P<0.001).
CONCLUSION
Transthoracic echocardiography, routinely used in patients with RMVS, can measure EAT to determine patients who are under risk for thrombus.
Topics: Adipose Tissue; Adult; Aged; Cross-Sectional Studies; Echocardiography, Transesophageal; Female; Heart Atria; Humans; Male; Middle Aged; Mitral Valve Stenosis; Thrombosis
PubMed: 32864926
DOI: 10.21470/1678-9741-2019-0303