Levisman J A, Abbasi A S, Pearce M L
Circulation. 1975 Mar;51(3):511-4. doi: 10.1161/01.cir.51.3.511.
A reduced rate of diastolic closure of the anterior mitral leaflet has been shown to occur in mitral stenosis, primary pulmonary hypertension, and in cases with reduced left ventricular compliance. Posterior notion of the posterior mitral leaflet in diastole has been the distinguishing feature to rule out the diagnosis of mitral stenosis. We have analyzed echocardiograms of 167 patients with mitral stenosis and have found 16 cases where the posterior mitral leaflet moved posteriorly, that is, in an opposite direction from the anterior mitral leaflet. Two other features were found that were helpful in establishing the diagnosis of mitral stenosis in these atypical cases, namely, thickening of the mitral leaflets and reduction or absence of the artrial wave.
二尖瓣狭窄、原发性肺动脉高压以及左心室顺应性降低的病例中，已显示二尖瓣前叶舒张期关闭速率降低。二尖瓣后叶在舒张期的向后运动一直是排除二尖瓣狭窄诊断的显著特征。我们分析了167例二尖瓣狭窄患者的超声心动图，发现其中16例二尖瓣后叶向后移动，即与二尖瓣前叶的移动方向相反。还发现了另外两个有助于在这些非典型病例中确诊二尖瓣狭窄的特征，即二尖瓣叶增厚以及心房波减弱或消失。
