Abstract: AIM To investigate the correlation between the peak velocities of mitral annuli during systole and diastole and the recovery of patients with rheumatic mitral stenoses (MS) after operation of mitral valve (MV) replacement. METHODS Forty-four patients with pure rheumatic MS undergoing MV replacement were divided into good recovery group and poor recovery group. Specimens of papillary muscles were collected during operations for pathological analyses. Vs, the mean of peak velocity of mitral annulus during ejection phase and Ve, the mean of peak velocity of mitral annulus during early diastolic phases were measured by Doppler tissue imaging (DTI) before and after MV replacement. All the measurements were compared between the two groups. RESULTS Vs before and after MV replacement and Ve before MV replacement in the good recovery group were significantly larger than those in the poor recovery group. Ratio of fibrous tissue to myocardia was significantly larger in the poor recovery group compared with that in the fine recovery group. No statistical differences in other measurements was found between the two groups. CONCLUSION Association between recovery and DTI measurements and between recovery and myocardial fibrosis are found, which suggests that velocities of mitral annulus measured by DTI can be used to estimate noninvasively the prognoses of patients undergoing MV replacements.