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VOLUME 2 , ISSUE 3 ( September-December, 2023 ) > List of Articles


Echocardiographic Assessment of Mitral Valve

Satyen Parida, Muthapillai Senthilnathan, Chitra R Thangaswamy

Keywords : Echocardiography, Mitral, Mitral regurgitation, Mitral stenosis, Mitral valve

Citation Information : Parida S, Senthilnathan M, Thangaswamy CR. Echocardiographic Assessment of Mitral Valve. 2023; 2 (3):144-152.

DOI: 10.5005/jp-journals-10089-0041

License: CC BY-NC 4.0

Published Online: 19-02-2024

Copyright Statement:  Copyright © 2023; The Author(s).


Echocardiography is the principal method for the estimation of the structure and function of the mitral valve (MV). Impedance to mitral inflow is caused essentially by mitral stenosis (MS) of rheumatic origin. Less common causes involve tumors, principally myxomas, calcification of the mitral annulus, carcinoid heart disease, and congenital MS. When associated with exclusive valvular and subvalvular affliction, severe MS is diagnosed with a pressure half-time (PHT) of >150 ms and valve area ≤1.5 cm2. In MS of rheumatic origin, echocardiography enables evaluation of the likelihood of success for percutaneous balloon valvotomy. Echocardiography allows appraisal of the degree of mitral regurgitation (MR) and helps discern various causes such as prolapse or flail of MV segments, endocarditis of mitral leaflets, rheumatic etiology, ischemic MR, or functional MR as seen in cardiomyopathy.

  1. Edle I, Hertz CH. Ultrasound cardiogram in mitral valve disease. Acta Chir Scand 1956;111:230–231.
  2. Edler I. Ultrasoundcardiography in mitral valve stenosis. Am J Cardiol 1967;19(1):18–31. DOI: 10.1016/0002-9149(67)90258-5
  3. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. Circulation 2021;143(5):e35–e71. DOI: 10.1161/CIR.0000000000000932
  4. Foster GP, Isselbacher EM, Rose GA, et al. Accurate localization of mitral regurgitant defects using multiplane transesophageal echocardiography. Ann Thorac Surg 1998;65(4):1025–1031. DOI: 10.1016/s0003-4975(98)00084-8
  5. Mor-Avi V, Jenkins C, Kühl HP, et al. Real-time 3-dimensional echocardiographic quantification of left ventricular volumes: multicenter study for validation with magnetic resonance imaging and investigation of sources of error. JACC Cardiovasc Imaging 2008;1(4):413–423. DOI: 10.1016/j.jcmg.2008.02.009
  6. Lang RM, Badano LP, Tsang W, et al. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr 2012;25(1):3–46. DOI: 10.1016/j.echo.2011.11.010
  7. Altiok E, Hamada S, Brehmer K, et al. Analysis of procedural effects of percutaneous edge-to-edge mitral valve repair by 2D and 3D echocardiography. Circ Cardiovasc Imaging 2012;5(6):748–755. DOI: 10.1161/CIRCIMAGING.112.974691
  8. Nichol PM, Gilbert BW, Kisslo JA. Two-dimensional echocardiographic assessment of mitral stenosis. Circulation 1977;55(1):120–128. DOI: 10.1161/01.cir.55.1.120
  9. Birnbaum Y, Chamoun AJ, Conti VR, et al. Mitral regurgitation following acute myocardial infarction. Coron Artery Dis 2002;13(6):337–344. DOI: 10.1097/00019501-200209000-00006
  10. Douedi S, Douedi H. Mitral Regurgitation. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2023 Feb 1]. Available from:
  11. Tribouilloy C, Shen WF, Quéré JP, et al. Assessment of severity of mitral regurgitation by measuring regurgitant jet width at its origin with transesophageal doppler color flow imaging. Circulation 1992;85(4):1248–1253. DOI: 10.1161/01.cir.85.4.1248
  12. Zoghbi WA, Adams D, Bonow RO, et al. Recommendations for noninvasive evaluation of native valvular regurgitation: a report from the American society of echocardiography developed in collaboration with the society for cardiovascular magnetic resonance. J Am Soc Echocardiogr 2017;30:(4)303–371. DOI: 10.1016/j.echo.2017.01.007
  13. Shah PM. Current concepts in mitral valve prolapse—diagnosis and management. J Cardiol 2010;56(2):125–133. DOI: 10.1016/j.jjcc.2010.06.004
  14. Varma PK, Krishna N, Jose RL, et al. Ischemic mitral regurgitation. Ann Card Anaesth 2017;20(4):432–439. DOI: 10.4103/aca.ACA_58_17
  15. Saxena A. Echocardiographic diagnosis of chronic rheumatic valvular lesions. Glob Heart 2013;8(3):203–212. DOI: 10.1016/j.gheart.2013.08.007
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