TT Mitral Prolapse

Mitral Valve Disease, end-systolic prolapse

February 28, 2021
(updated April 14th, 2022)

End-systolic Prolapse, Posterior Leaflet 收缩末期脱垂, 后叶

Figure 1. 2d parasternal long axis mitral valve 图1. 2d胸骨旁长轴二尖瓣
Figure 2 M-mode mitral valve 图2 M型二尖瓣, end-systolic prolapse
Figure 2. M-mode mitral valve 图2 M型二尖瓣
Figure 3. 2d parasternal llong axis mitral valve 图3. 2d胸骨旁长轴二尖瓣. Frame by frame analysis
Figure 3. 2d parasternal long axis mitral valve 图3. 2d胸骨旁长轴二尖瓣

(tt4045) F, 56 y. 2D and M-mode imaging of a mild end-systolic prolapse of the PML. There is no significant regurgitation. Note the M-mode sign of the end-systolic prolapse of the PML (parallel lines bending posteriorly; horizontal arrow) and the hyperkinesis of the base of the LV posterior wall which on the M-mode tracing is seen as a large notch in the myocardium of the posterior wall (vertical arrow). The notch is caused by the hyperkinetic posterior wall moving out of the M-mode scanning beam (2D imaging, Fig. 1 and 2D sequential systolic frames in Fig. 3). Fig. 3 also shows that there is no MAD (mitral annulus dysjunction) in this case because the MV annulus is connected to the posterior LV myocardium (Fig. 3, frame #7, vertical arrow) throughout systole.
A: late diastolic opening (atrial systole) of AML; C: closure point of the MV; D: opening point of the MV; E: early diastolic opening (LV relaxation and fast LV filling); F: early diastolic closure (end of LV relaxation); AML:= anterior mitral leaflet; PML: posterior leaflet.

二尖瓣后叶收缩末期轻度脱垂的2D及M型图像。无明显返流。注意M型中收缩末期二尖瓣后叶脱垂信号(向后弯曲的平行线；水平箭头)，以及左室后壁基底段运动过度，在M型图像轨迹中可见后壁心肌呈较大凹陷(竖直箭头)。这个凹陷的形成是由于后壁运动过度而移出了M型扫描声束的范围(图1，2D图像；图3，2D收缩期连续帧图)。图3也显示了此病例中没有MAD(二尖瓣环分离)，因为二尖瓣环整个收缩期都连接于左室后壁心肌处(图3,#7帧, 竖直箭头)。
A: 舒张末期前叶打开 (心房收缩期); C: 二尖瓣闭合点; D: 二尖瓣开放点; E: 舒张早期打开 (左室松弛及快速左室充盈); F: 舒张早期关闭 (左室松弛结束); AML:二尖瓣前叶; PML: 二尖瓣后叶