Shiu M F, Jenkins B S, Webb-Peploe M M
Br Heart J. 1978 Apr;40(4):372-6. doi: 10.1136/hrt.40.4.372.
Echocardiographic analysis of the movement of the posterior mitral valve leaflet in 60 patients with lone mitral stenosis, 35 patients with aortic stenosis, and 18 patients with aortic and mitral stenosis showed a spectrum of initial posterior mitral valve leaflet movement in early diastole. The classical anterior movement was seen in 36 out of 60 patients with mitral stenosis (60%), and 8 out of 16 patients with aortic and mitral stenosis (50%). Normal posterior movement was present in all patients with lone aortic stenosis but was also seen in 10 patients (17%) with mitral stenosis and 6 patients (33%) with aortic and mitral stenosis. The remaining patients with mitral stenosis or aortic stenosis and mitral stenosis showed a biphasic type of initial movement. Patients with anterior movement had a mean calculated mitral valve area from cardiac catheterisation significantly smaller than the rest (P less than 0.001), but neither biphasic nor posterior movement excluded severe mitral stenosis. The distinction between patients with mitral stenosis and initial movement of the posterior mitral valve leaflet and patients with left ventricular discompliance is possible when there is sinus rhythm. Late diastolic anterior movement of the posterior mitral valve leaflet during atrial contraction is diagnostic of true mitral stenosis.
对60例单纯二尖瓣狭窄患者、35例主动脉瓣狭窄患者及18例主动脉瓣和二尖瓣狭窄患者的二尖瓣后叶活动进行超声心动图分析，结果显示舒张早期二尖瓣后叶活动呈现一系列变化。60例二尖瓣狭窄患者中有36例（60%）出现典型的向前运动，16例主动脉瓣和二尖瓣狭窄患者中有8例（50%）出现这种情况。所有单纯主动脉瓣狭窄患者均出现正常的向后运动，但在10例（17%）二尖瓣狭窄患者和6例（33%）主动脉瓣和二尖瓣狭窄患者中也可见到。其余二尖瓣狭窄或主动脉瓣狭窄合并二尖瓣狭窄的患者表现为双相型初始运动。向前运动的患者经心导管检查计算出的平均二尖瓣面积明显小于其他患者（P<0.001），但双相运动或向后运动均不能排除重度二尖瓣狭窄。当存在窦性心律时，二尖瓣狭窄患者与二尖瓣后叶初始运动以及左心室顺应性降低患者之间的区别是可能的。心房收缩期二尖瓣后叶舒张晚期向前运动可诊断为真正的二尖瓣狭窄。
