Cardiac Valve Z-Scores

Determine z-scores for the mitral valve, aortic valve, tricuspid valve, and pulmonic valve using this calculator. The regression equations are those from Cincinnati Children's Hospital, based on over 700 children between the ages of 0-18 years.

Location Measured Mean Range Z-Score

Also see these derivative works:


Two-dimensional echocardiographic valve measurements in healthy children: gender-specific differences. Zilberman MV, Khoury PR, Kimball RT. Pediatr Cardiol. 2005 Jul-Aug;26(4):356-60. Erratum in: Pediatr Cardiol. 2008 Mar;29(2):475.

Previous Comments

On Friday Sep 28 2007, F Bennett Pearce, MD said:

very nice, if you could put a BSA calculator on the same page it would be even better

On Friday Sep 28 2007, Dan said:

Thanks, that's a good point- I will definitely add one.
I did not build one in initially, because there is no mention in the article about how the authors calculated their BSA for this study.
I can add one with a user-selectable choice for BSA formula...

*edit* I should learn to read more closely. The authors indeed disclose that the BSA is "calculated by Dubois formula"

On Sunday Sep 30 2007, Dan said:

added BSA calculation...
Wikipedia and Steven B. Halls, MD.

Thanks for the suggestion.
Let me know if this doesn't suit the need.

On Friday Nov 09 2007, Paulo Manso, MD said:

Thank you This is a very useful tool Congratulations!

On Sunday Nov 11 2007, Dhamelisse Then said:

this will be very helpfull for us here, thanks a lot!!!!!!!!

On Sunday Nov 11 2007, Dan said:

I am glad you are finding it useful. Gracias a Ustedes!

On Wednesday Nov 14 2007, Dr Smita Mishra said:

Thanks. Thanks.It is very helpful. Please include Z score for pulmonary arterteries and ventricular dimensions. Smita Mishra Pediatric Cardiologist Max heart & vascular Institute, Saket New Delhi. India.

On Wednesday Nov 14 2007, Dan said:

I use the published literature as the source for these calculators... as yet, I have not found a suitable reference for the PA's or chamber sizes.
I welcome your suggestions though!

On Thursday Nov 29 2007, maitri chaudhuri said:

We would appreciate if you display the full range of pedaitric cardiac z scores. not only the valves

On Thursday Dec 06 2007, Sri Rao, MD said:

Very user-friendly, thank you so much.

On Friday Dec 07 2007, Dan said:

@ maitri: the z-scores from this calculator are based upon the Zilberman et al. article in Pediatric Cardiology- they only published z-scores for the valves.

@ Sri: You're welcome!

On Friday Feb 08 2008, SS Kothari said:

This is just fantastic.

On Thursday Mar 20 2008, Beverley said:

My son is 13 years old with a diagnosis of aortic stenosis ( mild to moderate) mild aortic insufficiency and a mod aortic root enlargement 3.5 cm. I was recently told he had a Z score of 6 and was asked to consider a beta blocker, this is a congenital diagnosis he does not have Marfans. I was wondering if you could give me an idea where to go to read more about how Z scores are scored and what that score means? Thanks so much!

On Thursday Mar 20 2008, Dan said:

Beverley: you should really discuss this with your son's pediatric cardiologist!

On Friday Mar 21 2008, Leslie A Flores, MD said:

Could you please add z scores for LVPW and IVS. Thanks!!!!!

On Saturday Apr 26 2008, Lily said:

Very useful, thanks!

On Tuesday May 27 2008, Nikola Tede MD said:

Great resource, thank you

On Monday Jun 30 2008, zhang yuqi said:

very good. thanks! i used to calculate Z score manually, it is clumsy.

On Wednesday Jul 16 2008, Jorge Faerron said:

Excellent. Thanks. Hospital Nacional de Ninos. Costa Rica.

On Wednesday Sep 10 2008, Jake Jaquiss said:

As a surgeon who is in the position of trying to achieve a certain z score with reconstruction, it would be helpful to be given small table with two columns: structure diameter and z score, for a given BSA. It would also be more consistent with clinical practice if the structure measurement input were in millmeters instead of centimeters, since that is how we size these valve on echo. These are vey minor bookkeeping issues, though. Overall, this is an absolutely terrific service you have provided to our community. Thank you very much.

On Wednesday Sep 10 2008, Dan said:

Dear Dr. Jaquiss:

Thanks for taking the time to provide your feedback on the z-score calculator.

From the perspective of the sonographer, the calculated z-score is just what gets the patient from the echo lab to you... I never thought to use the data from the other side of the coin (so to speak).

I'll be working on your proposed adaptation to the Cincinnati valve z-score data directly.