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Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure
Methodist Debakey Heart & Vasc Ctr, Ctr Outcomes Res, Houston Methodist Res Inst, Houston, TX USA.
Univ Calif San Francisco, Div Cardiol, San Francisco, CA 94143 USA.
Univ Massachusetts, Sch Med, Dept Med, Worcester, MA USA.
Leiden Univ, Med Ctr, Dept Cardiol, Leiden, Netherlands.
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2019 (English)In: Circulation Cardiovascular Imaging, ISSN 1941-9651, E-ISSN 1942-0080, Vol. 12, no 1, article id e008122Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Assessment of left ventricular (LV) filling pressure is among the important components of a comprehensive echocardiographic report. Previous studies noted wide limits of agreement using 2009 American Society of Echocardiography/European Association of Echocardiography guidelines, but reproducibility of 2016 guidelines update in estimating LV filling pressure is unknown.

METHODS:

Echocardiographic and hemodynamic data were obtained from 50 patients undergoing cardiac catheterization for clinical indications. Clinical and echocardiographic findings but not invasive hemodynamics were provided to 4 groups of observers, including experienced echocardiographers and cardiology fellows. Invasively acquired LV filling pressure was the gold standard.

RESULTS:

In group I of 8 experienced echocardiographers from the guidelines writing committee, sensitivity for elevated LV filling pressure was 92% for all observers, and specificity was 93 +/- 6%. Fleiss kappa-value for the agreement in group I was 0.80. In group II of 4 fellows in training, sensitivity was 91 +/- 2%, and specificity was 95 +/- 2%. Fleiss kappa-value for the agreement in group II was 0.94. In group III of 9 experienced echocardiographers who had not participated in drafting the guidelines, sensitivity was 88 +/- 5%, and specificity was 91 +/- 7%. Fleiss kappa-value for the agreement in group III was 0.76. In group IV of 7 other fellows, sensitivity was 91 +/- 3%, and specificity was 92 +/- 5%. Fleiss kappa-value for the agreement in group IV was 0.89.

CONCLUSIONS:

There is a good level of agreement and accuracy in the estimation of LV filling pressure using the American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 recommendations update, irrespective of the experience level of the observer.

Place, publisher, year, edition, pages
2019. Vol. 12, no 1, article id e008122
Keywords [en]
diastole, echocardiography, echocardiography, Doppler, guideline, humans
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-379243DOI: 10.1161/CIRCIMAGING.118.008122ISI: 000459456800005PubMedID: 30632389OAI: oai:DiVA.org:uu-379243DiVA, id: diva2:1296936
Available from: 2019-03-18 Created: 2019-03-18 Last updated: 2019-03-18Bibliographically approved

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