A multicentric quality-control study of exercise Doppler echocardiography of the right heart and the pulmonary...

Area of Science:

• Cardiology
• Echocardiography
• Pulmonary Circulation

Background:

• Echocardiography is crucial for assessing cardiac function.
• Standardization of echocardiographic measurements is essential for reliable clinical interpretation.
• Exercise Doppler echocardiography (EDE) provides dynamic functional information.

Purpose of the Study:

• To evaluate the quality control and inter-observer agreement of resting and exercise Doppler echocardiography (EDE) variables.
• To assess the reproducibility of EDE measurements across experienced echocardiography laboratories.

Main Methods:

• A quality-control study involving 19 experienced echocardiography laboratories.
• Investigators reported variables from 10 randomly selected exercise stress tests.
• Inter-observer agreement was assessed using intraclass correlation coefficients (ICC) for various resting and exercise echocardiographic parameters.

Main Results:

• Accuracy for all measured variables ranged from 99.7% to 100%.
• Intraclass correlation coefficients (ICC) were consistently above 0.90 for all observers.
• Low inter-observer variability was observed for most parameters, including tricuspid regurgitation velocity (TRV) and tricuspid annular plane systolic excursion (TAPSE), with moderate variability for right ventricular fractional area change (RV FAC).

Conclusions:

• Exercise Doppler echocardiography (EDE) is a reproducible method for assessing right heart and pulmonary circulation parameters.
• High accuracy and inter-observer agreement confirm the reliability of EDE when performed in expert centers.
• Findings support the use of EDE as a robust diagnostic tool in experienced clinical settings.