A study of mitral valve action recorded by reflected ultrasound and its application in the diagnosis of mitral stenosis.

The movements of two ultrasound echo signals, believed to arise from the anterior mitral leaflet and from the mitral ring, were studied in 30 normal subjects and in 100 heart-catheterization patients. Fifty patients had proven mitral stenosis. The echo from the anterior mitral leaflet is shown to have a complex pattern of movement. This pattern is analyzed into the opening and closing movements of the leaflet, and the underlying movement transmitted from the mitral ring. In the normal condition, the characteristic feature of leaflet motion is a sharp closing movement that follows the initial opening in diastole. This sharp closing movement is not seen in the presence of mitral stenosis. It is believed that the demonstration of a sustained wide-open poisition of the leaflet in diastole has the same diagnostic significance as the finding of a persistent positivepressure gradient across the valve. The value of this method in diagnosing the severity of the stenosis is discussed.