Test-Retest Variability of Volumetric Right Ventricular Measurements Using Real-Time Three-Dimensional Echocardiography

Heleen Zwaan, Marcel Geleijnse, Osama Soliman, Jackie Mcghie, EJA Wiegers-Groeneweg, W.A. Helbing, Jolien Roos - Hesselink, FJ (Folkert) Meijboom

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Abstract

Background: Substantial variability in sequential echocardiographic right ventricular (RV) quantification may exist. Interobserver and intraobserver values are well known, but acquisition (test-retest) variability has been rarely assessed. The objective of this study was to determine the test-retest variability of sequential RV volume and ejection fraction (EF) measurements by real-time three-dimensional echocardiography in patients with congenital heart disease and healthy controls. Methods: Twenty-eight participants (21 patients with congenital heart disease, seven healthy controls; mean age, 30 +/- 14 years; 43% men) underwent a series of three echocardiographic studies. To obtain interobserver and intraobserver test-retest variability, two sonographers acquired sequential RV data sets in each participant during one outpatient visit. RV volumetric quantification was done using semiautomated three-dimensional border detection. The variability data were analyzed using correlation coefficients, Bland-Altman analysis, and coefficients of variation. Results: Absolute mean differences for sequential intraobserver acquisitions were 12 +/- 12 mL for end-diastolic volume, 7 +/- 6 mL for end-systolic volume, and 4 +/- 3% for EF. Interobserver and intraobserver test-retest variability, respectively, were 7% and 7% for RV end-diastolic volume, 14% and 7% for endsystolic volume, and 8% and 6% for EF. Conclusions: Good test-retest variability, besides the practical nature of real-time three-dimensional echocardiography for RV volume and EF assessment, makes it a valuable technique for serial follow-up. Although it may be challenging to diminish all factors that can influence echocardiographic examination for serial follow-up, standardization of RV size and functional measurements should be a goal to produce more interchangeable data. (J Am Soc Echocardiogr 2011; 24:671-9.)
Original languageUndefined/Unknown
Pages (from-to)671-679
Number of pages9
JournalJournal of the American Society of Echocardiography
Volume24
Issue number6
DOIs
Publication statusPublished - 2011

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