Pressure and sound correlates of the mitral valve ecyocardiogram in mitral stenosis.

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Abstract
The pressure and sound correlates of the mitral valve echocardiogram (MVE) were investigated in 10 patients with mild to moderate mitral stenosis using high fidelity catheter tip micromanometers. Slow and rapid phases of the MVE anterior motion at the time of opening are associated with the slow and rapid phases of the left atrial y descent. The slow MVE motion and the slow y descent begin isovolumic left ventricular relaxation when left ventricular pressure still exceeds left atrial pressure. The rapid MVE anterior motion and the rapid y descent begin with pressure crossover. Posterior motion of the MVE at the time of closure also occurs in 2 phases. After the onset of left ventricular pressure rise at end-diastole, a slow posterior motion is associated with a rising left atrial c wave. Rapid posterior motion begins with pressure crossover and is completed near the peak of the C wave. The fall in left atrial pressure during valve opening can be related to movement of the mitral valve away from the left atrium with the fall in left ventricular (LV) pressure, During valve closure, the rising left atrial (LA) pressure can be related to the ascent of the mitral valve toward the left atrium. Both the mitral component of the 1st heart sound and the opening snap occur at points of maximum MVE excursion and after LV-LA pressure crossover.