Journal Article

Reproducibility in Echocardiographic Assessment of Diastolic Function in a Population Based Study (The STANISLAS Cohort Study)

Courand, Pierre Yves, Bozec, Erwan, Rossignol, Patrick, Frikha, Zied, Olivier, Arnaud, Lamiral, Zohra, Girerd, Nicolas, Zannad, Faiez, Huttin, Olivier

2015

Overview

There is limited evidence regarding intra-observer and inter-observer variations in echocardiographic measurements of diastolic function. This study aimed to assess this reproducibly within a population-based cohort study. Sixty subjects in sinus rhythm were randomly selected among 4th visit participants of the STANISLAS Cohort (Lorraine region, France). This 4th examination systematically included M-mode, 2-dimensional, DTI and pulsed-wave Doppler echocardiograms. Reproducibility of variables was studied by intra-class correlation coefficients (ICC) and Bland Altman plots. Our population was on average middle-aged (50 ± 14 y), overweight (BMI = 26 ± 6 kg/m2) and non-smoking (87%) with a quarter of the participants having self-declared hypertension or treated with anti-hypertensive medication(s). Intra-observer ICC were > 0.90 for all analyzed parameters except for left ventricular ejection fraction (LVEF) which was 0.89 (0.81-0.93). The mean relative intra-observer differences were small and limits of agreement of relative differences were narrow for all considered parameters (<5% and <15% respectively). Inter-observer ICC were > 0.90 for all analyzed parameters except for LVEF (ICC = 0.87) and both mitral and pulmonary A wave duration (0.83 and 0.73 respectively). The mean relative inter-observer differences were <5% for all parameters except for pulmonary A wave duration (mean difference = 6.5%). Limits of agreement of relative differences were narrow (<15%), except for mitral A wave duration and velocity (both <20%) as well as left ventricular mass and pulmonary A wave duration (both <30%). Intra-observer agreements with regard to the presence and severity of diastolic dysfunction were excellent (Kappa = 0.93 (0.83-1.00) and 0.88 (0.75-0.99), respectively). In this validation study within the STANISLAS cohort, diastolic function echocardiographic parameters were found to be highly reproducible. Diastolic dysfunction consequently appears as a highly effective clinical and research tool.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Antihypertensive Agents - therapeutic use / Antihypertensives / Blood Flow Velocity - physiology / Blood pressure / Body mass / Body weight / Cardiology and cardiovascular system / Cohort analysis / Cohort Studies / Correlation analysis / Correlation coefficient / Correlation coefficients / Diagnosis / Diastole - physiology / Doppler effect / Drugs / Echocardiography / Female / France / Heart / Heart Failure - diagnosis / Heart Failure - physiopathology / Human health and pathology / Humans / Hypertension / Hypertension - drug therapy / Hypertension - physiopathology / Life Sciences / Male / Measurement / Middle Aged / Overweight / Population studies / Population-based studies / Reproducibility / Sinus / Smoking / Ventricle / Ventricular Function, Left - physiology