Interobserver Reproducibility of the Visual Echocardiographic Scoring System for Left Ventricular Filling Pressure

Background The visually assessed time difference between mitral and tricuspid valve opening (VMT) scoring is a simple B-mode echocardiographic method for estimating left ventricular filling pressure (LVFP). This study aimed to evaluate the interobserver reproducibility of VMT scoring between a resident doctor using a handheld ultrasound device and experienced sonographers using a stationary system. Methodology In this prospective observational study, 27 inpatients underwent two echocardiographic examinations on the same day: a handheld ultrasound performed by a resident doctor and standard echocardiography performed by cardiac sonographers. Both observers independently assessed VMT scores (0-3) based on the time sequence of atrioventricular valve opening and inferior vena cava findings. Interobserver agreement was evaluated using weighted kappa statistics. Results Among the 27 patients (mean age = 76 ± 12 years; 56% female), 11 (41%) had a VMT score ≥2, indicating elevated LVFP. The weighted kappa value for interobserver agreement was 0.97, demonstrating almost-perfect concordance regardless of operator experience or device type. Conclusions VMT scoring appears to be a practical and reliable method for LVFP evaluation in diverse clinical settings, particularly those with limited access to expert echocardiography.