Related Experiment Videos
Intra- and interobserver reproducibility of Doppler-assessed indexes of left ventricular diastolic function in a
M Galderisi1, E J Benjamin, J C Evans
1Cardiology Department, Boston City Hospital, Massachusetts.
Insights
This study assessed Doppler indexes of diastolic function reproducibility in sinus rhythm and atrial fibrillation. Most measurements showed good intra- and interobserver reproducibility, crucial for epidemiologic studies.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Reproducibility of Doppler indexes for diastolic function in epidemiologic settings and atrial fibrillation is not well-established.
- Left ventricular inflow Doppler assessment is key for evaluating diastolic function.
Purpose of the Study:
- To examine the reproducibility of Doppler indexes of left ventricular diastolic function.
- To evaluate these indexes in subjects with sinus rhythm and atrial fibrillation within an epidemiologic context.
Main Methods:
- Assessed Doppler indexes including early (E) and late (A) diastolic inflow velocities, E/A ratios, and atrial filling fraction.
- Evaluated intraobserver and interobserver variability using bias, correlation coefficients, and precision measures.
- Included 80 subjects in sinus rhythm and 12 in atrial fibrillation from the Framingham Heart Study.
Main Results:
- Most peak and integral Doppler measures demonstrated high intra- and interobserver correlations (≥0.89) and good precision (<13%).
- Time-based measures like acceleration, deceleration, and pressure half-time showed lower correlations and precision.
- Interobserver bias was statistically significant for most parameters but generally <10% in sinus rhythm subjects.
Conclusions:
- Doppler indexes of left ventricular diastolic function exhibit acceptable reproducibility for epidemiologic studies, particularly peak and integral velocity measures.
- Time-based Doppler parameters may have limitations in reproducibility compared to velocity and integral measures.
- Findings support the use of Doppler echocardiography for assessing diastolic function in large-scale population studies.
Abstract:
The reproducibility of a variety of Doppler indexes of diastolic function in an epidemiologic setting and in atrial fibrillation have not been reported. This study examined the reproducibility of left ventricular inflow in subjects in sinus rhythm (n = 80) and atrial fibrillation (n = 12), randomly selected from the original cohort of the Framingham Heart Study. The following Doppler indexes were assessed for all subjects: peak and integral of early (E) diastolic inflow velocity, acceleration slope and time, deceleration slope and time, and pressure half-time. For subjects in sinus rhythm, the following parameters also were measured: the peak and integral of late (A) diastolic inflow velocity, ratios of peak velocities and integrals E/A, and atrial filling fraction. Intraobserver and interobserver variability were evaluated by statistical methods including Student's t test of the systematic differences (bias), percent bias, correlation coefficients, measurement precision, and percent precision. In subjects in sinus rhythm, although the interobserver bias was statistically significant for most of the parameters, it was < 10% for all but 1 parameter (acceleration time). For the peak and integral measures, the intra- and interobserver correlations were > or = 0.89, with intra- and interobserver percent precision measures within 2.2 to 13.0% of the corresponding mean values. The acceleration, deceleration and pressure half-time measures had somewhat lower correlations (interobserver correlations ranging from 0.59 to 0.96), with percent precision measures further from the corresponding means (interobserver percent precision ranging from 10.1 to 19.5%).(ABSTRACT TRUNCATED AT 250 WORDS)