Echocardiography can predict which patients will develop severe mitral regurgitation after percutaneous mitral valvulotomy

Padial, Luis Rodrı́guez; Freitas, Nelmacy; Sagie, Alex; Newell, John; Weyman, Arthur E.; Levine, Robert A.; Palacios, Igor F.

doi:10.1016/0735-1097(95)00594-3

Cited by 128 publications

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“…3 Although this scoring method has been widely used because of its simplicity and reasonable success in separating patients with successful versus unsuccessful outcomes based on an increase in valve area, the grading of individual components remains semiquantitative, subject to observer variability, and less reliable in classifying patients with scores within the midrange. Furthermore, it does not include assessment of commissural morphology [4][5][6][7] and thus does not assess postprocedural mitral regurgitation (MR), which is an important predictor of long-term outcome. [8][9][10][11][12][13][14][15] Several subsequent models that seek to include a prediction of MR have been proposed; however, the best combination of parameters to predict both outcome variables remains to be defined.…”

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The Echo Score Revisited

et al. 2014

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Background-Current echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations.This study examined new, more quantitative methods for assessing valvular involvement and the combination of parameters that best predicts immediate and long-term outcome after PMV. Methods and Results-Two cohorts (derivation n=204 and validation n=121) of patients with symptomatic mitral stenosis undergoing PMV were studied. Mitral valve morphology was assessed by using both the conventional Wilkins qualitative parameters and novel quantitative parameters, including the ratio between the commissural areas and the maximal excursion of the leaflets from the annulus in diastole. Independent predictors of outcome were assigned a points value proportional to their regression coefficients: mitral valve area ≤1 cm 2 (2), maximum leaflets displacement ≤12 mm (3), commissural area ratio ≥1.25 (3), and subvalvular involvement (3). Three risk groups were defined: low (score of 0-3), intermediate (score of 5), and high (score of 6-11) with observed suboptimal PMV results of 16.9%, 56.3%, and 73.8%, respectively. The use of the same scoring system in the validation cohort yielded suboptimal PMV results of 11.8%, 72.7%, and 87.5% in the low-, intermediate-, and high-risk groups, respectively. The model improved risk classification in comparison with the Wilkins score (net reclassification improvement 45.2%; P<0.0001). Long-term outcome was predicted by age and postprocedural variables, including mitral regurgitation, mean gradient, and pulmonary pressure. Conclusions-A scoring system incorporating new quantitative echocardiographic parameters more accurately predicts outcome following PMV than existing models. Long-term post-PMV event-free survival was predicted by age, degree of mitral regurgitation, and postprocedural hemodynamic data. (Circulation. 2014;129:886-895.)

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“…Transthoracic 2D echocardiography allows classification of patients into anatomic groups to predict immediate and long-term outcome [17,18]. Although most cardiologists use the Wilkins score, several echocardiographic scoring systems have been suggested for evaluation of MV anatomy [19][20][21][22]. None of the available scores has been shown to be superior to any of the others [23].…”

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Usefulness of the Global Echo-Doppler Score (GEDS) in selection of patients with mitral stenosis for percutaneous balloon mitral valvuloplasty

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“…16 Immediate results of PTMC are predicted from mitral valve anatomy as was evident in many studies. Regarding the procedural success and hemodynamic effects of PTMC very few studies have been done and data in Pakistan is not sufficient.…”

Section: Wwwtheprofesionalcom Percutaneous Transmitral Commissurotomentioning

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Percutaneous Transmitral Commissurotomy (Ptmc); Procedural Success and Immediate Results, a Tertiary Care Hospital Experience From Developing Country

Asghar

Riaz

Hussain

2016

TPMJ

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Echocardiography can predict which patients will develop severe mitral regurgitation after percutaneous mitral valvulotomy

Abstract: This new mitral regurgitation echocardiographic score can predict the development of severe mitral regurgitation after percutaneous mitral valvulotomy and can be useful in the selection of patients for this technique.

Cited by 128 publications

References 20 publications

The Echo Score Revisited

The Echo Score Revisited

Usefulness of the Global Echo-Doppler Score (GEDS) in selection of patients with mitral stenosis for percutaneous balloon mitral valvuloplasty

Percutaneous Transmitral Commissurotomy (Ptmc); Procedural Success and Immediate Results, a Tertiary Care Hospital Experience From Developing Country

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