Clinical ResearchVariability in the Echocardiographic Evaluation of the Systemic Right Ventricle
Section snippets
Study population
The study population was selected among 144 patients with simple (isolated) or complex (associated with other congenital lesions) TGA/AS and 68 patients with ccTGA without anatomic repair, aged 18 years or greater and followed at the Montreal Heart Institute Adult Congenital Center. Eligible patients were identified through the institutional tailored clinical and research informatics system for congenital heart disease (Congenital Evaluation, Reporting, and Tracking Endeavor [CONGENERATE]),
Population
Demographic and clinical characteristics of the study population are summarized in Tables 1 (TGA/AS) and 2 (ccTGA).
Quantitative parameters
For the interobserver comparison, ICC ranged from 0.491 to 0.752 corresponding to a fair to excellent agreement between the 6 observers for sRV inlet and longitudinal diameters, FAC, and systolic and diastolic areas (Table 3). The CV was < 15% for all previously described parameters except FAC. For the intraobserver comparison, the ICC ranged from 0.497 to 0.967 corresponding to a
Variability in qualitative and quantitative sRV evaluation
In this study of interobserver and intraobserver variability of quantitative and qualitative echocardiographic parameters for sRV size and systolic function, the main findings are as follows: (1) fair to excellent interobserver (ICC, 0.491-0.752, Table 3) and intraobserver correlations (ICC, 0.497-0.967, Table 4) for most quantitative parameters (sRV inlet and longitudinal diameters, systolic and diastolic area, FAC calculation); (2) very strong intraobserver agreement for measurements of sRV
Conclusions
Quantitative parameters of sRV size and systolic function have a good agreement between observers. Qualitative appreciation of sRV size and systolic function show good intraobserver agreement albeit with discordant results between observers. These findings suggest that an overall appreciation of sRV size and systolic function relies on variable interpretation of measurements by observers combined with individual judgement and experience. These findings support the notion of standardizing the
Acknowledgements
Drs Chaix and Mongeon thank the Montreal Heart Institute Foundation for its support. Dr Labombarda thanks the Société Française de Cardiologie for its support.
Funding Sources
This research was supported by the Montreal Heart Institute Foundation.
Disclosures
The authors have no conflicts of interest to disclose.
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