Defining minimal detectable difference in echocardiographic measures of right ventricular function in systemic...

Area of Science:

• Cardiology
• Rheumatology
• Medical Imaging

Background:

• Two-dimensional echocardiography (2DE) is crucial for screening and monitoring pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc).
• Establishing the reliability and reproducibility of 2DE parameters is essential for accurate patient assessment.

Purpose of the Study:

• To determine the reliability, repeatability, and reproducibility of 2DE parameters in SSc patients with and without PAH.
• To define the minimal detectable difference (MDD) for these echocardiographic measures.

Main Methods:

• Systemic sclerosis patients with and without PAH underwent 2DE at two time points.
• Statistical analyses included ANOVA, coefficients of variation (CV), intraclass correlation, and Bland-Altman analysis.
• MDD was calculated using the standard error of measurement for each parameter.

Main Results:

• Most 2DE parameters demonstrated minimal differences between evaluations.
• Global right ventricular longitudinal systolic strain (GRVLSS) and fractional area change (FAC) showed the largest CVs.
• Excellent intra- and inter-observer agreement was observed, with defined MDD values for key parameters like TAPSE, FAC, and RVSP.

Conclusions:

• Clinically significant 2DE measures in SSc patients with/without PAH exhibit minimal measurement error.
• Defined MDD values are vital for accurate PAH screening, therapeutic response assessment, and clinical trial design in SSc.