An easy‐to‐use scoring index to determine severity of mitral regurgitation by 2D echocardiography in clinical practice

Jansen, Rosemarijn; Hart, Einar A.; Peters, Max; Urgel, Kim; Kluin, Jolanda; Tietge, Wouter J.; Zwart, Koen; Sybrandy, Kirsten C; Chamuleau, Steven A.J.

doi:10.1111/echo.13636

Cited by 4 publications

(5 citation statements)

References 51 publications

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“…In 3 echocardiograms (0.7%) severe MR was misdiagnosed. A total of 27 patients with MR grade < 3, and 15 patients with MR grade ≥ 3 had a ROSE-index score of 2 or 3, meaning that in 10% of the patients additional diagnostics and/ or evaluation in a heart valve team is recommended [25].…”

Section: Echocardiographic Resultsmentioning

confidence: 99%

“…Ideal would be a "scoring system" for accurate and reproducible MR grading in both pre-and post-TAVR echocardiograms. We proposed the 5-parameter ROSE-index, to aid the treating physician in how to use the integrated approach as recommended by the guidelines for the determination of MR severity in patients undergoing TAVR [25]. Although the index was originally developed to distinguish moderate from severe MR in clinical practice, it correctly determined MR severity in 89% of our study patients.…”

Section: Grading Methodsmentioning

confidence: 99%

“…This averaged value was based on at least 3 beats. We calculated the right ventricular systolic pressure using the modified Bernoulli Next, the mitral RegurgitatiOn Severity grading by an Easy-to-use index (ROSE-index) was determined [25]. The ROSE-index is a semiquantitative approach to determine MR severity using 5 instead of 11 recommended echo variables: ROSE-index score = (valve morphology * 1) + (jet characteristics * 2) + (vena contracta * 2) + (systolic reversal * 2) + (LV dimensions * 1).…”

Section: Echocardiographic Evaluationmentioning

confidence: 99%

“…This practical tool showed reliable and reproducible assessment of severe MR (cut-off ≥ 4) in a retrospective analysis of 145 patients with moderate or severe MR. Expert panel consensus reading was considered as the reference standard [25].…”

Section: Echocardiographic Evaluationmentioning

confidence: 99%

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Evaluation of mitral regurgitation by an integrated 2D echocardiographic approach in patients undergoing transcatheter aortic valve replacement

Jansen

Wind

Nijhoff

et al. 2018

Int J Cardiovasc Imaging

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The purpose of this study was to evaluate mitral regurgitation (MR) severity in patients undergoing transcatheter aortic valve replacement (TAVR) by standardized assessment of two-dimensional (2D) transthoracic echocardiography (TTE) and 1-year echocardiographic and clinical outcomes. Pre-and post-procedural TTE's of patients undergoing TAVR between 2008 and 2014 were analyzed. MR was graded according to current guidelines with a systematic and integrated approach. Longitudinal echocardiographic and clinical results were analyzed. Regression analysis was performed for change in MR grade at follow-up, using pre-determined variables and confounders. Pre-and post-procedural TTE were available in 213 subjects. Significant MR was seen in 22% at baseline and 15% at follow-up; MR grade ≥ 3 in < 10%. Severity did not change in 61%, and decreased in 20% of the patients. Overall, the prevalence of MR grades pre-and post TAVR was not significantly different, nor influenced by MR etiology or TAVR prosthesis type. However, higher MR grades and pacemaker absence at baseline, were independently correlated to more improvement of MR after TAVR. Regarding clinical outcomes, NYHA class improved in two-thirds of the patients, irrespective of the baseline MR grade. Overall survival was not significantly different amongst MR grades post-TAVR. MR grading using an systematic 2D echocardiographic approach in patients undergoing TAVR is feasible in clinical practice. Our data revealed a relatively frequent prevalence of significant MR (although grade ≥ 3 was scarce), overall no change in the MR grade at 1 year follow-up, improvement of functional NYHA class, and no significant differences in long-term survival amongst the post-TAVR MR grades.

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Section: Echocardiographic Resultsmentioning

confidence: 99%

Section: Grading Methodsmentioning

confidence: 99%

Section: Echocardiographic Evaluationmentioning

confidence: 99%

Section: Echocardiographic Evaluationmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of mitral regurgitation by an integrated 2D echocardiographic approach in patients undergoing transcatheter aortic valve replacement

Jansen

Wind

Nijhoff

et al. 2018

Int J Cardiovasc Imaging

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“…Our findings support the need for improvement of care in VHD patients, which might be achieved by early valve repair or replacement. However, the complexity of the interplay between CCS and VHD on symptoms (24), cardiac damage (25,26), and clinical course (27) make appropriate timing of intervention difficult (28).…”

Section: Valvular Heart Disease In Patients With Chronic Coronary Syn...mentioning

confidence: 99%

The impact of valvular heart disease in patients with chronic coronary syndrome

Molenaar

Bouma

Coerkamp

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThe European Society of Cardiology 2019 Guidelines on chronic coronary syndrome (CCS) recommend echocardiographic measurement of the left ventricular function for risk stratification in all patients with CCS. Whereas CCS and valvular heart disease (VHD) share common pathophysiological pathways and risk factors, data on the impact of VHD in CCS patients are scarce.MethodsClinical data including treatment and mortality of patients diagnosed with CCS who underwent comprehensive transthoracic echocardiography (TTE) in two tertiary centers were collected. The outcome was all-cause mortality. Data were analyzed with Kaplan-Meier curves and Cox proportional hazard analysis adjusting for significant covariables and time-dependent treatment.ResultsBetween 2014 and 2021 a total of 1,984 patients with CCS (59% men) with a median age of 65 years (interquartile range [IQR] 57–73) underwent comprehensive TTE. Severe VHD was present in 44 patients and moderate VHD in 325 patients. A total of 654 patients (33%) were treated with revascularization, 39 patients (2%) received valve repair or replacement and 299 patients (15%) died during the median follow-up time of 3.5 years (IQR 1.7–5.6). Moderate or severe VHD (hazard ratio = 1.33; 95% CI 1.02–1.72) was significantly associated with mortality risk, independent of LV function and other covariables, as compared to no/mild VHD.ConclusionsVHD has a significant impact on mortality in patients with CCS additional to LV dysfunction, which emphasizes the need for a comprehensive echocardiographic assessment in these patients.

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Quantification of Mitral Valve Regurgitation from 4D Flow MRI Using Semiautomated Flow Tracking

Blanken¹,

Westenberg²,

Aben³

et al. 2020

Radiology: Cardiothoracic Imaging

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To compare the accuracy of semiautomated flow tracking with that of semiautomated valve tracking in the quantification of mitral valve (MV) regurgitation from clinical four-dimensional (4D) flow MRI data obtained in patients with mild, moderate, or severe MV regurgitation. Materials and Methods: The 4D flow MRI data were retrospectively collected from 30 patients (21 men; mean age, 61 years 6 10 [standard deviation]) who underwent 4D flow MRI from 2006 to 2016. Ten patients had mild MV regurgitation, nine had moderate MV regurgitation, and 11 had severe MV regurgitation, as diagnosed by using semiquantitative echocardiography. The regurgitant volume (Rvol) across the MV was obtained using three methods: indirect quantification of Rvol (Rvol INDIRECT ), semiautomated quantification of Rvol using valve tracking (Rvol VALVE ), and semiautomated quantification of Rvol using flow tracking (Rvol FLOW ). A second observer repeated the measurements. Aortic valve flow was quantified as well to test for intervalve consistency. The Wilcoxon signed rank test, orthogonal regression, Bland-Altman analysis, and coefficients of variation were used to assess agreement among measurements and between observers.

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An easy‐to‐use scoring index to determine severity of mitral regurgitation by 2D echocardiography in clinical practice

Cited by 4 publications

References 51 publications

Evaluation of mitral regurgitation by an integrated 2D echocardiographic approach in patients undergoing transcatheter aortic valve replacement

Evaluation of mitral regurgitation by an integrated 2D echocardiographic approach in patients undergoing transcatheter aortic valve replacement

The impact of valvular heart disease in patients with chronic coronary syndrome

Quantification of Mitral Valve Regurgitation from 4D Flow MRI Using Semiautomated Flow Tracking

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