[M-mode and two-dimensional echocardiography in evaluating mitral stenosis before and after commissurotomy]

A first group of 51 patients with pure or predominant mitral stenosis underwent M-mode (M) and two-dimensional (2D) echocardiography and cardiac catheterization (cath). After elimination of 3 incomplete cases, the series consists of 48 patients. 20 later underwent surgery. Quantitative correlations between M and cath are poor (r = 0.34, p less than 0.05); however, correlations between 2D and cath were excellent (r = 0.89, p less than 0.001). There were 4 major discrepancies between 2D and cath: 3 of these patients were operated upon and surgery confirmed 2D mitral valve area in all of them. 2D had served to diagnose all 6 cases of mitral calcifications seen at surgery; however, M provided 1 false negative and 5 false positive results with regard to diagnosis of calcifications. A second group consisted of 18 patients who had undergone mitral commissurotomy, 8 of these had a pre- and postoperative echocardiography. 10 also underwent postoperative cath. M appeared to be unable to predict correctly the presence or absence of a recurrence of mitral stenosis. Quantitative correlations between diastolic slope and mitral valve area at cath were poor. However, excellent correlations were found between 2D and cath, showing that 2D also serves to measure mitral valve area after commissurotomy.