Reproducibility of quantitative pediatric transesophageal echocardiography

Transesophageal echocardiography (TEE) is commonly used to monitor cardiac function and to assess cavitary size. For the interpretation of quantitative echocardiographic data, the degree of their reproducibility should be considered. The variability of quantitative TEE was evaluated in this study. To assess intraobserver, beat-to-beat, interobserver, and repositioning variability, TEE examinations of 46 patients with congenital heart defects were analyzed. The mean beat-to-beat variability of 8.5% (range 4.2% to 12.3%) exceeded the mean intraobserver variability of 4.9% (1.9% to 8.1%). The mean interobserver difference between two observers was 3.4% (0.2% to 11.9%). Differences in image acquisition caused by repositioning of the transesophageal probe contributed the most (6.4% to 13.3%; mean 10.5%) to the variability of two-dimensional TEE. Changes seen on TEE studies should be interpreted as abnormal only when they exceed the total variability of this method.