Abstract

Objective: Evaluation of the severity of mitral stenosis using mitral leaflet separation index and its significance over planimetry and pressure half time method especially in patients with Atrial fibrillation.

Material and Methods: This study was a hospital based prospective study which was done in S.N Medical College Agra. It was conducted on the patients attending O.P.D and also on those admitted in PG Department of Medicine, S N Medical College, Agra. It included both patients who were already diagnosed and also those who were diagnosed for the first time in our department. A total of 100 cases between 18-60 yrs of age were included in the study. Cases already diagnosed with mitral stenosis but have undergone valvuloplasty or with severe co-morbid illnesses or other underlying cardiac abnormalities like infective endocarditis, atrial septal defect, ventricular septal defect were excluded from the study. Severity of mitral stenosis was also assessed using Planimetry and Pressure Half Time

Results: The correlation coefficient between the mitral leaflet separation index and the mitral valve area as measured by planimetry is 0.962 and the coefficient of determination is 0.927 which shows a very high correlation between both the methods. The correlation coefficient between the mitral leaflet separation index and the mitral valve area as measured by planimetry is 0.9555 and the coefficient of determination is 0.913 which shows a very high correlation between both the methods. The correlation coefficient between the mitral leaflet separation index and the mitral valve area as measured by planimetry is 0.895 and the coefficient of determination is 0.802 which shows a very high correlation between both the methods. The correlation coefficient between the mitral leaflet separation index and the mitral valve area as measured by planimetry is 0.836 and the coefficient of determination is 0.7 which shows a very high correlation between both the methods.

Conclusion: MLS index is a reliable method which can be used to assess severity of Mitral stenosis, and it may also be used as surrogate to current methods of assessment but not as a substitute for other echo parameters. This index would also help when there is a inconsistency between severities of MS estimated by present methods, in the existence of atrial fibrillation and in the presence of mitral regurgitation or where it is not possible to perform MVA calculation by planimetry. Especially in patients with Atrial fibrilaton where pressure half time method is not reliable and planimetry is not able to assess the area accurately due to poor echo window, Mitral leaflet separation index can be used as relable method to assess the severity.

Keywords: Mitral Leaflet Seperation Index, severity of mitral stenosis, assessment of severity of mitral stenosis in presence of atrial fibrillation, measurement of MVA by planimetry, measurement of MVA by pressure half-time method.