Echocardiography in assessment of mitral valve disease II. Left atrium and left ventricle

79 patients studied by cardiac catheterization were also studied by echocardiography to evaluate the reliability and usefulness of echocardiography in making left atrial and ventricular measurements in patients with mitral valve disease. The left atrium was larger than normal in all the patients and especially in those with mitral regurgitation. There was a significant correlation between the mean pulmonary capillary wedge pressure and the left atrial diameter in the patients with a stenotic component, and the left atrial diameter seems to correlate better than the cineangiographic left atrial size with the atrial pressure as the anterior-posterior atrial dilatation is more pressure dependent. In atrial fibrillation the left atrial diameter was greater than in the patients with sinus rhythm, but there was a great overlap in atrial diameters between these patient groups. In 37% of the patients with a mitral regurgitation component a systolic bulge caused by a regurgitant jet was found in the posterior left atrial wall, the appearance and magnitude of which depended more on the properties of the atrial wall and the direction of the regurgitant jet than on the amount of regurgitation. The results concerning left ventricular size and function agreed well with the previous cineangiographic studies. There was good correlation between the cineangiographically and echocardiographically measured left ventricular volumes and ejection fractions, but left atrial dilatation made the correlation less close.