Interstudy reproducibility of parameters of left ventricular diastolic function: a Doppler echocardiography study

Interstudy reproducibility of echocardiography for the assessment of parameters of left ventricular (LV) diastolic function is disputed. Therefore, we evaluated the reproducibility of echocardiography for assessment of LV diastolic Doppler parameters in 40 consecutive patients (age range: 19-77 years), who underwent 2 echocardiographic examinations by trained sonographers following a standard protocol, in conditions in which intrapatient sources of variability were minimized.

Interstudy reproducibility of measurements of the ratio of early (E) to late (A) peak velocities of transmitral flow (E/A) at tips of the mitral valve leaflets was found to be very good and substantially greater than analogous measurement obtained at mitral annulus level. Reproducibility of measurement of atrial filling fraction was good both at tips of mitral leaflets and at annular level. Interstudy reproducibility of isovolumic relaxation time and E-wave deceleration time was moderate. Measurements of E-wave propagation rate and the ratio of early (E') to late (A') peak velocities of diastolic excursion of lateral mitral annulus (E'/A') by Doppler tissue were found highly reproducible. Intrastudy between-reading reproducibility of Doppler parameters of LV diastolic function were overall very good, except for E-wave deceleration time. However, 80% confidence interval of absolute between-study differences of diastolic parameters were relatively large, and ranged from -0.11 to +0.19 for E/A at tips of mitral valve; -5 to +9 cm/s for E-wave propagation rate; and -0.69 to +0.19 for Doppler tissue-derived E'/A'.

Under a standardized echocardiographic protocol and sonographers' training program, echocardiography can be a reproducible method for serial assessment of Doppler parameters of LV diastolic function, especially in cohort studies.