Pulsed Doppler Echocardiographic Left Ventricular Inflow Velocity Patterns of Mitral Stenosis and Severity Grading

摘要

42 patients with mitral stenosis(MS), diagnosed by M-mode, 2-D sector scan and pulsed Doppler echocardiography, were evaluated. Among them 28 patients were complicated with atrial fibrillation and one foruth was normal sinus rhythm. Pulsed Doppler echocardiographic left ventricular inflow velocity patterns(PELVIVP) were compaired with the EF slop of anterior mitral valve leaflet. The results were as follows; The normal PELVIVP showed a biphasic pattern during diastole. PEVIVP in MS were classified into 5 types and measured EF slop of anterior mitral valve leaflet in each type. Type I was characterized by a biphasic flow pattern showing a relative increase in the atrial contraction wave compared with the rapid filling wave and the prolonged deceleration time. EF slop was 24.7±6.1mm/sec. Type II was turbulent scaphoid pattern during diastole. EF slop was 14.5±4.4mm/sec. Type IIIa was monophasic with gradual descending slop during diastole. EF slop was 16.9±4.0mm/sec. Type IIIb was also turblent monophasic with gradual ascending slop during diastole. EF slop was 8.1±2.3mm/sec. Type IV was diastolic turblent and was characterized by dome shaped pattern. EF slop was 7.9±1.9mm/sec. There was a significant correlation between the 3 groups(I, II and IIIa, IIIb and IV) of LVIVP in MS and EF slop(P This result indicated that type I of the flow pattern was well observed in mild MS, type II and IIIa in moderate MS, and type IIIb and IV in severe MS. Pulsed Doppler flow pattern in MS was alterable in the atrial fibrillation.