Document Detail


Accuracy and Interobserver Concordance of Echocardiographic Assessment of Right Ventricular Size and Systolic Function: A Quality Control Exercise.
MedLine Citation:
PMID:  22542275     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Accurate assessment of right ventricular (RV) size (RVS) and RV systolic function (RVSF) is vital in the management of various conditions, but their assessment is challenging using echocardiography. The aim of this study was to determine the accuracy and interobserver concordance of qualitative and quantitative RV echocardiography. METHODS: Fifteen readers evaluated RV function in 12 patients (360 readings) who underwent echocardiography and cardiac magnetic resonance for RV assessment. Readers qualitatively estimated RVS and RVSF as normal, mild, moderate, or severe and then reassessed quantitatively by adding RV dimensions, fractional area change, S', tricuspid annular plane systolic excursion, and RV index of myocardial performance. Cardiac magnetic resonance was used as the reference standard for grading RVS and RVSF. RESULTS: Quantitative measurements increased accuracy and interreader agreement compared to qualitative assessment alone, especially in normal categories. Readers' accuracy for diagnosing normal and severe RVS increased from 38% to 78% (P = .001) and from 70% to 97% (P = .018), and readers' accuracy for diagnosing normal and mild RVSF increased from 52% to 84% (P < .001) and from 36% to 56% (P = .001). Interreader agreement for classification of the subjects as normal or abnormal improved from a κ value of 0.40 to 0.77 (fair to good agreement) for RVS and from 0.43 to 0.66 (moderate to good agreement) for RVSF. CONCLUSIONS: Visual estimation of RVS and RVSF is inaccurate and has wide interobserver variability. Quantitation improves accuracy and reliability, especially in distinction of normal and abnormal. The reliability of mild and moderate grades remains inadequate, and further guidance is needed for the classification of abnormal categories.
Authors:
Lee Fong Ling; Nancy A Obuchowski; Leonardo Rodriguez; Zoran Popovic; Deborah Kwon; Thomas H Marwick
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-26
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  -     ISSN:  1097-6795     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.
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