Echocardiographic evaluation with hemodynamic correlation of the left ventricle in mitral stenosis

The value of echocardiographic measurement of left ventricle volume and ejection fraction and of mitral valve area in patients with mitral stenosis has been assessed. All patients referred because of mitral stenosis have been studied by M-mode and two-dimensional echocardiography, by right and left heart catheterization, ventriculography and selective coronary angiography. Patients with other congenital or acquired heart disease or with coronary artery disease were excluded from this study. The selection lead to a series of 39 pts, all with a typical history of Rheumatic Fever: all these pts were divided in three groups according to the degree of mitral stenosis, classified as "mild", if valvular area was greater than 1.8 cm2 (8 pts), "moderate" between 1-1.8 cm2 (15 pts) and "severe" if valvular areas was less than 1 cm2 (16 pts). In all groups echocardiography underestimated left ventricular volumes as well as stroke volumes. Statistical correlation has not been excellent: the best result was again obtained in the calculation of ejection fraction (r = 0.91, P less than 0.001), confirming our previous results in a group of patients with mitral regurgitation. Cross-sectional two-dimensional echocardiography has confirmed, furthermore, as a sensitive and suitable procedure in assessing the mitral valve area (r = 0,87 P less than 0.001); at our experience echocardiography under-estimate mitral area in the cases of severe mitral stenosis.