Table 1.

Different Ultrasound Cardiac Calcification Grading Score. (A) Cardiac calcification grading score proposed by Tolstrup et al. [73]. (B) Semiquantitative Calcium Score Index (CSI) proposed by Corciu et al. [74] and modified and adopted by Gaibazzi et al. [72]. (C) Global cardiac calcium ultrasound score elaborated by Pressman et al. [77]. (D) Echocardiographic calcification score “echoCCS” proposed by Hirschberg et al. [80].

(A) Tolstrup et al. [73]	Grade	Aortic Valve Sclerosis		Mitral Annulus Calcification		Aortic Atheromatous Disease
Final Score Range: 0–10	0	No thickening		Normal		Normal, <2 mm intimal thickness
	1	Slight ↑ reflectance, thickness < 2 mm		<5 mm		Intimal thickness 2–4 mm
	2	Mild ↑ reflectance, thickness 2–4 mm		5–10 mm		Intimal thickness > 4 mm
	3	Generalized hyper-reflectance, thickness > 4 mm		>10 mm		Any protruding/mobile plaque
	4	Markedly hyper-reflectant masses, thickness > 6 mm
(B) Corciu et al. [74]	Grade	Papillary Muscle Calcium	Mitral Annular Calcium	Aortic Valve Sclerosis		Aorta Root Calcium
Final Score Range: 0–8	0	Absent	Absent	Normal cusp thickness (<2mm) and normal reflectivity		Absent
	1	Present	<5 mm	Cusp thickness > 2 mm and/or increased reflectivity		Present
	2		5–10 mm	Thickness > 4 mm and/or diffuse or focal cusp hyperreflectivity
	3		>10 mm	Thickness > 6mm and/or marked echoreflectivity
(C) Pressman et al. [77]	Grade	Posterior Annulus Calcium	Posterior Mitral Leaflet Restriction	Anterior Annulus Calcium	Anterior Mitral Leaflet Restriction	Mitral Valve Calcium	Subvalvular Apparatus Calcium	Aortic Valve Calcium	Aortic Root Calcium
Final Score Range: 0–13	0	Absent	Absent	Absent	Absent	Absent	Absent	Absent	Absent
	1	1/3 of annulus	Present	Present (any mobility reduction)	Present (valve opening <10mm)	Mild	Present	Nodules in <3 leaflets	Present
	2	2/3 of annulus				>Mild		Nodules in 3 leaflets but non-restrictive
	3	3/3 of annulus						Restrictive (meam gradient > 15 mmHg or reduced leaflets motion)
(D) Hirschberg et al. [80]	Grade	Papillary Muscle Calcium		Mitral Annular Calcium		Aortic Valve Sclerosis		Aorta Root Calcium	Septal Calcium
Final Score Range: 0–5	0	Absent		Absent		Absent		Absent	Absent
	1	Present		Present		Present		Absent	Present