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[Echocardiographic evaluation of mitral valve calcification]
G R Ciliberto1, G Pomè, F Casolo
1Divisione Cardiologica De Gasperis, Ente Ospedaliero Ca'Granda Niguarda, Milano.
Giornale Italiano Di Cardiologia
|October 1, 1990
Summary
Echocardiography (ECHO) accurately assesses mitral valve (MV) calcifications, aiding surgical planning for rheumatic heart disease. This study found ECHO comparable to inspection and radiography for grading MV calcifications.
Area of Science:
- Cardiology
- Medical Imaging
- Valvular Heart Disease
Background:
- Preoperative assessment of mitral valve (MV) calcifications is crucial for selecting the appropriate surgical approach in patients with mitral valve disease.
- Rheumatic heart disease commonly affects the mitral valve, often leading to calcification that impacts valve function and surgical management.
Purpose of the Study:
- To evaluate the accuracy of echocardiography (ECHO) in the semiquantitative analysis of mitral valve (MV) calcifications.
- To compare ECHO findings with direct inspection, radiography (X-ray), and quantitative calcium extraction (QCa) for grading MV calcifications.
Main Methods:
- Sixty-six patients undergoing MV replacement for rheumatic disease were preoperatively studied using a standardized ECHO method.
- Echocardiograms were analyzed by two independent observers, identifying calcifications as dense echoes.
- Post-excision, MVs were assessed by inspection (I), X-ray, and QCa (EDTA spectrophotometry) for grading: absent (1), mild (2), nodular (3), and diffuse (4).
Main Results:
- No significant differences were found between ECHO, I, and X-ray grading using the chi-square test.
- ECHO and X-ray showed high concordance, while I grading was slightly lower than X-ray (P < 0.002).
- Variance analysis revealed significant differences in QCa within mild and nodular calcification groups (P < 0.002 and P < 0.001, respectively), attributed to lower sensitivity of inspection.
Conclusions:
- Echocardiography is a reliable method for semiquantitative assessment of mitral valve calcifications.
- ECHO findings correlate well with direct inspection and radiography, providing valuable preoperative data for surgical planning.
- Established QCa values ( < 20 mg, 20-80 mg, > 80 mg) can guide the classification of absent/mild, nodular, and diffuse MV calcifications, respectively.