Echocardiographic Study of Mitral Stenosis

The value of pulsed Doppler echocardiography in the assessment of mitral stenosis was studied in a consecutive series of 175 patients before rightand left-heart catheterization. All Doppler recordings were interpreted independently by two observers. Twenty patients had repeat studies to demonstrate the reproducibility of the method. Adequate recordings were obtained in 156 patients. A normal flow pattern was observed in all 41 patients in sinus rhythm without a mitral valve gradient but in none of the 51 patients in sinus rhythm with a mitral gradient. In atrial fibrillation the normal pattern was identified in all three patients with no mitral gradient but in none of the 61 with a gradient. Three patterns of mitral valve flow could be distinguished that corresponded to mild, moderate and severe stenosis. The mitral valve gradient in the 36 patients with pattern I was 6.1 ± 1.7 mm Hg (SD) (range 3-10 mm Hg); in 54 patients with pattern II it was 12.0