EchocardiographyExercise StressMiscEchocardiography
Aortic Valve Velocity RatioLV EF (Modified Quinones Equation)Myocardial Performance Index (RV)
AVA (Continuity Equation VTI)LV EF (Simplified Quinones Equation)PCWP by E/Ea (Nagueh Formula)
AVA (Continuity Equation VMax)LV Fractional ShorteningPISA (Mitral regurgitation)
dP/dt (LV contractility)LV Mass and LV Mass IndexPISA (Mitral stenosis)
dP/dt (RV contractility)Mitral valve area (PHT)Qp/Qs
Left atrial pressure (MR)Mitral Valvuloplasty Score (MGH)RVSP (TR)
LA Volume (Biplane Method)Modified Bernoulli EquationStroke Volume, Cardiac Output
LV EF (Dumesnil Method)Myocardial Performance Index (LV)
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Mitral Valvuloplasty Score (MGH)

Calculation


Item Rating Value
Leaflet Mobility Highly mobile 1

Reduced mobility

2
Basal leaflet motion only 3
Minimal motion 4
Valve Thickening Near normal (4-5 mm) 1
Thickened tips 2
Entire leaflet thickened (5-8 mm) 3
Marked leaflet thickening (>8-10 mm) 4
Calcification Single area of brightness 1
Scattered areas at leaflet margins 2
Brightness extends to mid leaflets 3
Extensive leaflet brightness 4
Subvalvular Thickening Minimal chordal thickening 1
Chordal thickening up to 1/3 2
Distal third of chordae thickening 3
Extensive thickening to pap muscle 4


Mitral Valve Score
Outcome
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Information

In patients undergoing mitral valvuloplasty for mitral stenosis, an echocardiographic scoring system based on 1) leaftlet mobility, 2) valve thickening, 3) calcification, 4) subvalvular thickening can be used to predict the procedural outcome. Each item is graded from 1 (normal) to 4 which yield a score from 4 to 16. A score of 8 or less predicts a more favorable outcome than those with a higher score. However, a score higher than 8 does not exclude a patient from having a mitral valvuloplasty. Commissural calcification or fusion is another important predictor for poor outcome after mitral valvuloplasty.

Mitral Valve Score = Leaflet Mobility + Valve Thickening + Calcification + Subvalvular Thickening

Variable
Leaflet Mobility
1 Highly mobile
2 Reduced mobility
3 Basal leaflet motion only
4 Minimal motion
Valve thickening
1 Near normal (4-5 mm)
2 Thickened tips
3 Entire leaflet thickened (5-8 mm)
4 Marked leaflet thickening (>8-10 mm)
Calcification
1 Single area of brightness
2 Scattered areas at leaflet margins
3 Brightness extends to mid leaflets
4 Extensive leaflet brightness
Subvalvular thickening
1 Minimal chordal thickening
2 Chordal thickening up to 1/3
3 Distal third of chordae thickening
4 Extensive thickening to pap muscle

References


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