Test-Retest Variability of Volumetric Right Ventricular Measurements Using Real-Time Three-Dimensional Echocardiography

• Published in: Journal of the American Society of Echocardiography Vol. 24; no. 6; pp. 671 - 679
• Main Authors: van der Zwaan, Heleen B., MD, Geleijnse, Marcel L., MD, PhD, Soliman, Osama I.I., MD, PhD, McGhie, Jackie S., MSc, Wiegers-Groeneweg, Ellen J.A, Helbing, Willem A., MD, PhD, Roos-Hesselink, Jolien W., MD, PhD, Meijboom, Folkert J., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.06.2011
• Subjects: Adult; Cardiovascular; Case-Control Studies; Echocardiography, Three-Dimensional - methods; Female; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - physiopathology; Humans; Male; Prospective Studies; Real-time three-dimensional echocardiography; Reproducibility of Results; Right ventricular quantification; Stroke Volume; Test-retest variability; Ventricular Dysfunction, Right - congenital; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - physiopathology; EF; RV; Real-time three-dimensional echocardiography; CMR; Congenital heart disease; Test-retest variability; 3D; Three-dimensional; Right ventricular quantification; Cardiac magnetic resonance; RT3DE; Right ventricular; CHD; Ejection fraction
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2011.02.007

Background Substantial variability in sequential echocardiographic right ventricular (RV) quantification may exist. Interobserver and intraobserver values are well known, but acquisition (test-retest) variability has been rarely assessed. The objective of this study was to determine the test-retest variability of sequential RV volume and ejection fraction (EF) measurements by real-time three-dimensional echocardiography in patients with congenital heart disease and healthy controls. Methods Twenty-eight participants (21 patients with congenital heart disease, seven healthy controls; mean age, 30 ± 14 years; 43% men) underwent a series of three echocardiographic studies. To obtain interobserver and intraobserver test-retest variability, two sonographers acquired sequential RV data sets in each participant during one outpatient visit. RV volumetric quantification was done using semiautomated three-dimensional border detection. The variability data were analyzed using correlation coefficients, Bland-Altman analysis, and coefficients of variation. Results Absolute mean differences for sequential intraobserver acquisitions were 12 ± 12 mL for end-diastolic volume, 7 ± 6 mL for end-systolic volume, and 4 ± 3% for EF. Interobserver and intraobserver test-retest variability, respectively, were 7% and 7% for RV end-diastolic volume, 14% and 7% for end-systolic volume, and 8% and 6% for EF. Conclusions Good test-retest variability, besides the practical nature of real-time three-dimensional echocardiography for RV volume and EF assessment, makes it a valuable technique for serial follow-up. Although it may be challenging to diminish all factors that can influence echocardiographic examination for serial follow-up, standardization of RV size and functional measurements should be a goal to produce more interchangeable data.