Echocardiographic studies of mitral valve motion. Genesis of the opening snap in mitral stenosis

The echocardiographic determination of mitral valve opening and closure. Correlation with hemodynamic studies in man.

“…The traditional C point defined by the most posterior movement is occasionally difficult to define. In addition, since the C point most often coincided with or followed the mitral component of the first heart sound,2' 7 which has been shown to lag hemodynamic crossover by 25 20 msec has been demonstrated in the canine preparation between an echocardiographic trace of the mitral valve anterior leaflet and clips on its free edge. '0 Thus one might speculate that the echocardiographic markers D' and CO, when corrected for such delays, may approximate the hemodynamic markers of opening and closure.…”

Relation of isovolumic relaxation to left ventricular wall movement in man.

“…Though measurement of isovolumic relaxation time ought to prove a simple means of quantifying such abnormalities in clinical practice, previous studies in this area have been few. The problem of defining the timing of mitral valve opening at the onset of ventricular filling has been a difficulty; several previous studies have used the 'O' point of the apex cardiogram (Benchimol and Ellis, 1967), but more recently it has been shown that this may be open to considerable error (Friedman, 1970;Prewitt et al, 1975). It was the purpose of the present study to reinvestigate this question, using echocardiography to time mitral valve opening, and thus determine the duration of isovolumic relaxation and its relation to left ventricular wall movement.…”

Estimation of Pulmonary Capillary Wedge Pressure from M-Mode Mitral Echograms

“…A study relating heart sounds to M-mode mitral echograms showed that the mitral opening snap occurs at, or is very close to, the time of E point of the mitral echograms [8]. It was also demonstrated that the A2-E interval measured by phonoechocardiography is also correlated with the left ventricu lar filling pressure [2][3][4] and is useful in evaluating the left ventricular filling pressure in those patients with and without mitral stenosis.…”