Table 2: Recommendation for classification of MS according to current guidelines(20)

MVA will be assessed by at least 2 methods.

I. Assessment LA Linear Dimensions and Area Measurements:

The anteroposterior diameter of the left atrium can be measured in the parasternal

long-axis view perpendicular to the long axis of the LA posterior wall, leading edge to

leading edge (M-mode) or inneredge to inner edge (2DE)., and measured at the level of

the aortic sinuses fig(5,6)(23).

Fig.5 (show LA dimension by 2DE) fig.6 (show LA dimension by

M- Mood)
 Standard LA Anterior- posterior Dimensions(23)

2-Left atrium volume and function assessment:

.
LA volume will be measured by biplane area–length method and indexed to body

surface area.

in biplane area–length method will be obtain at end-systole from the frame

immediately preceding mitral valve opening. Apical 4- and 2-chamber views have to be

of good quality with no foreshortening, the endocardial border must be Visualized and

the maximal area will be measured with a planimeter for 4- and 2-chamber views by

tracing the endocardial border, excluding area under the MV annulus, pulmonary veins,

and LA appendage. then length will be measure from the mid-line of the plane of mitral

annulus to the opposite superior aspect of the left atrium LA volume in this study will

calculated according to this formula:

LA Volume (AL) = 0.85 × (A4CH × A2CH)/ L . the L is average of the 2 lengths. As part
of quality control, we routinely checked for any foreshortening of the left atrium and
ensured that the 2 lengths did not differ by >5 mm. A difference of the 2 lengths by >5
mm would suggest the possibility of LA foreshortening lengths from 1 view, and we
remeasured the lengths to ensure accuracy(24) (figure 7).