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Circ Cardiovasc Imaging. 2017 Nov;10(11). pii: e006007. doi: 10.1161/CIRCIMAGING.116.006007.

Reproducibility of Left Ventricular Dimension Versus Area Versus Volume Measurements in Pediatric Patients With Dilated Cardiomyopathy.

Author information

1
From the Department of Pediatrics, Stanford University, Palo Alto, CA (E.S.S.T.); New England Research Institutes, Watertown, MA (D.H.-P., M.L., F.T.); Department of Pediatrics, St. Louis Children's Hospital, Washington University, MO (C.K.L.); Department of Pediatrics, New York Presbyterian Medical Center, Columbia University (K.A.); Department of Cardiology, Boston Children's Hospital, Harvard Medical School, MA (C.D.-M., S.D.C.); Department of Pediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada (F.G.); Department of Pediatrics, Duke University School of Medicine, Durham, NC (S.G.M.); Department of Pediatrics, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City (K.M.); Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, CA (S.N.); and Department of Pediatrics, Medical University of South Carolina, Children's Hospital of South Carolina, Charleston (C.L.T.). tierneys@stanford.edu.
2
From the Department of Pediatrics, Stanford University, Palo Alto, CA (E.S.S.T.); New England Research Institutes, Watertown, MA (D.H.-P., M.L., F.T.); Department of Pediatrics, St. Louis Children's Hospital, Washington University, MO (C.K.L.); Department of Pediatrics, New York Presbyterian Medical Center, Columbia University (K.A.); Department of Cardiology, Boston Children's Hospital, Harvard Medical School, MA (C.D.-M., S.D.C.); Department of Pediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada (F.G.); Department of Pediatrics, Duke University School of Medicine, Durham, NC (S.G.M.); Department of Pediatrics, Primary Children's Medical Center, University of Utah School of Medicine, Salt Lake City (K.M.); Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, CA (S.N.); and Department of Pediatrics, Medical University of South Carolina, Children's Hospital of South Carolina, Charleston (C.L.T.).

Abstract

BACKGROUND:

Multiple echocardiographic methods are used to measure left ventricular size and function. Clinical management is based on individual evaluations and longitudinal trends. The Pediatric Heart Network VVV study (Ventricular Volume Variability) in pediatric patients with dilated cardiomyopathy has reported reproducibility of several of these measures, and how disease state and number of beats impact their reproducibility. In this study, we investigated the impact of observer and sonographer variation on reproducibility of dimension, area, and volume methods to determine the best method for both individual and sequential evaluations.

METHODS AND RESULTS:

In 8 centers, echocardiograms were obtained on 169 patients prospectively. During the same visit, 2 different sonographers acquired the same imaging protocol on each patient. Each acquisition was analyzed by 2 different observers; first observer analyzed the first acquisition twice. Intraobserver, interobserver, interacquisition, and interobserver-acquisition (different observers and different acquisition) reproducibility were assessed on measurements of left ventricular end-diastolic dimension, area, and volume. Left ventricular shortening fraction, ejection fraction, mass, and fractional area change were calculated. Percent difference was calculated as (interobservation difference/mean)×100. Interobserver reproducibility for both acquisitions was better for both volume and dimension measurements (P≤0.002) compared with area measurements, whereas intraobserver, interacquisition (for both observers), and interobserver-acquisition reproducibilities (for both observer-acquisition sets) were best for volume measurements (P≤0.01). Overall, interobserver-acquisition percent differences were significantly higher than interobserver and interacquisition percent differences (P<0.001).

CONCLUSIONS:

In pediatric patients with dilated cardiomyopathy, compared with dimension and area methods, left ventricular measurements by volume method have the best reproducibility in settings where assessment is not performed by the same personnel.

CLINICAL TRIAL REGISTRATION:

URL: https://www.clinicaltrials.gov. Unique identifier: NCT00123071.

KEYWORDS:

cardiomyopathy; echocardiography; ejection fraction; pediatrics; shortening fraction

PMID:
29133477
PMCID:
PMC5705043
DOI:
10.1161/CIRCIMAGING.116.006007
[Indexed for MEDLINE]
Free PMC Article

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