Document Detail


The ventricular volume variability study of the Pediatric Heart Network: study design and impact of beat averaging and variable type on the reproducibility of echocardiographic measurements in children with chronic dilated cardiomyopathy.
MedLine Citation:
PMID:  22677278     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical trials often rely on echocardiographic measures of left ventricular size and function as surrogate end points. However, the quantitative impact of factors that affect the reproducibility of these measures is unknown. To address this issue, the National Heart, Lung, and Blood Institute-funded Pediatric Heart Network designed a longitudinal observational study of children with known or suspected dilated cardiomyopathy aged 0 to 22 years from eight pediatric clinical centers.
METHODS: Clinical data were collected together with 150 echocardiographic indices of left ventricular size and function. Separate observers performed duplicate echocardiographic imaging. Multiple observers performed measurements from three cardiac cycles to enable assessment of intraobserver and interobserver variability. The impacts of beat averaging (BA), observer type (local vs core), and variable type (areas, calculations, dimensions, slopes, time intervals, and velocities) on measurement reproducibility were studied. The outcome measure was percentage error (100 × difference/mean).
RESULTS: Of 173 enrolled subjects, 131 met criteria for dilated cardiomyopathy. BA, variable type and observer type all influenced percentage error (P < .0001). Core interobserver percentage error (medians, 11.4%, 10.2%, and 9.3% for BA using one, two, and three beats, respectively) was approximately twice the intraobserver percentage error (medians, 6.3%, 4.9%, and 4.2% for BA using one, two, and three beats, respectively). Slopes and calculated variables exhibited high percentage error despite BA. Chamber dimensions, areas, velocities, and time intervals exhibited low percentage error.
CONCLUSIONS: This comprehensive evaluation of quantitative echocardiographic methods will provide a valuable resource for the design of future pediatric studies. BA and a single core lab observer improve the reproducibility of echocardiographic measurements in children with dilated cardiomyopathy. Certain measurements are highly reproducible, while others, despite BA, are poorly reproducible.
Authors:
Steven D Colan; Girish Shirali; Renee Margossian; Dianne Gallagher; Karen Altmann; Charles Canter; Shan Chen; Fraser Golding; Elizabeth Radojewski; Michael Camitta; Michael Carboni; Jack Rychik; Mario Stylianou; Lloyd Y Tani; Elif Seda Selamet Tierney; Yanli Wang; Lynn A Sleeper;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-06-05
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  25     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-24     Completed Date:  2012-12-18     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  842-854.e6     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Affiliation:
Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts 02115, USA. colan@alum.mit.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00123071
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiomyopathy, Dilated / epidemiology*,  ultrasonography*
Child
Child, Preschool
Comorbidity
Echocardiography / statistics & numerical data*
Heart Ventricles / ultrasonography*
Humans
Image Enhancement / methods
Image Interpretation, Computer-Assisted / methods*
Infant
Infant, Newborn
Male
Organ Size
Prevalence
Reproducibility of Results
Risk Factors
Sensitivity and Specificity
United States / epidemiology
Ventricular Dysfunction, Left / epidemiology*,  ultrasonography*
Young Adult
Grant Support
ID/Acronym/Agency:
HL068269/HL/NHLBI NIH HHS; HL068270/HL/NHLBI NIH HHS; HL068279/HL/NHLBI NIH HHS; HL068281/HL/NHLBI NIH HHS; HL068285/HL/NHLBI NIH HHS; HL068288/HL/NHLBI NIH HHS; HL068290/HL/NHLBI NIH HHS; HL068292/HL/NHLBI NIH HHS; U01 HL068270/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
J Am Soc Echocardiogr. 2012 Aug;25(8):855-8   [PMID:  22824172 ]

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