Moller et al developed an echographic scoring scheme for evaluating severity of heart disease in patients with the carcinoid syndrome. This can help monitor patients over time and to detect cardiac disease progression. The authors are from the Mayo Clinic.
Parameters:
(1) tricuspid valve anatomy
(2) tricuspid valve regurgitation
(3) pulmonic valve anatomy
(4) pulmonic valve regurgitation
(5) right venticular size
(6) right ventricular function
(7) systolic flow reversal in hepatic veins
(8) diastolic forward flow in the pulmonary artery
|
Parameter |
Finding |
Points |
|---|---|---|
|
tricuspid valve anatomy |
normal |
0 |
|
|
thickened with reduced mobility |
1 |
|
|
thickened with severe immobility |
2 |
|
|
thickened and fixed |
3 |
|
tricuspid valve regurgitation |
none or minimal |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
pulmonic valve anatomy |
normal |
0 |
|
|
thickened with reduced mobility |
1 |
|
|
thickened with severe immobility |
2 |
|
|
thickened and fixed |
3 |
|
pulmonic valve regurgitation |
none or minimal |
0 |
|
|
mild |
1 |
|
|
moderate |
2 |
|
|
severe |
3 |
|
right ventricular size |
normal |
0 |
|
|
mildly enlarged |
1 |
|
|
moderately enlarged |
2 |
|
|
severely enlarged |
3 |
|
right ventricular function |
normal |
0 |
|
|
mildly impaired |
1 |
|
|
moderately impaired |
2 |
|
|
severely impaired |
3 |
|
systolic flow reversal in hepatic veins |
absent |
0 |
|
|
present |
1 |
|
diastolic forward flow in the pulmonary artery |
absent |
0 |
|
|
present |
1 |
total score =
= SUM(points for all 8 parameters)
change from baseline =
= ((current score) – (baseline score)) / (baseline score)
Interpretation:
• minimum score: 0
• maximum score: 20
• An increase in the score by >= 25% (> 5 points if baseline score 0) from baseline indicates clinically important progression of the heart disease.
Risk factors for progression:
(1) increasing 5-HIAA excretion in the level
(2) history of previous chemotherapy
Purpose: To evaluate a patient with carcinoid heart disease using echocardiography and the scoring scheme of Moller et al.
Specialty: Cardiology, Endocrinology, Hematology Oncology
Objective: imaging studies, criteria for diagnosis, severity, prognosis, stage
ICD-10: E34.0, I51.8,
