Abstract

STUDY OF A NOVEL INDEX MITRAL LEAFLET SEPARATION INDEX BY 2-DIMENSIONAL ECHOCARDIOGRAPHY TO ASSESS THE SEVERITY OF MITRAL STENOSIS

Author(s): Sumeet Garg1, Deepesh Agarwal2, Mohammed Shoaib3, Rupendra Kumar Bharti4

BACKGROUND
Mitral stenosis results due to structural abnormality of the mitral valve apparatus, which prevents proper opening of mitral valve during diastole. The Mitral Valve Area (MVA) can be measured by planimetry, pressure half time, continuity equation and proximal isovelocity surface area methods. Direct measurement of MVA by planimetry is accurate, but highly operator dependent and laborious. The novel index proposed by Seow in 2006. This is a mitral leaflet separation index, henceforth referred as MLS index, which is independent measure assessment of severity of mitral stenosis.
MATERIALS AND METHODS
The study was a prospective done from July 2014 to October 2014 in Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan. Fifty consecutive cases of mitral stenosis without significant other valvular lesion presenting to the Medicine OPD were studied. Identified the severity of mitral stenosis with the help of clinical, radiological, electrocardiographic features and correlates them with new index Mitral Leaflet Separation Index (MLS) with the help of two-dimensional echocardiography.
RESULTS
Mitral leaflet separation index was measured in all patients, of which, 12 patients (24%) were in mild mitral stenosis group. Moderate mitral stenosis was found in 13 (26%) patients, whereas 25 (50%) patients belongs to severe group. The mitral valve area by planimetry and pressure half time was correlated with mitral leaflet separation index and analysed with regression analysis, which suggest significant correlation in them. The correlation coefficient was (r) = 0.9551 and P value was <0.0001 was significant for the study.
CONCLUSION
The mitral leaflet separation index is a reliable measure of mitral stenosis severity and is technically easy to obtain. This new index could be a useful surrogate measure of the mitral valve area. This study almost conclusively states that the novel index-MLS index is decisive in assessing the severity of mitral stenosis.
KEYWORDS
Novel Index Mitral Leaflet Separation Index by 2-Dimensional Echocardiography.