Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure
Nagueh, S. F.; Abraham, T. P.; Aurigemma, G. P.et al.
2019 • In Circulation: Cardiovascular Imaging, 12 (1), p. 008122
[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 κ-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 κ-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 κ-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 κ-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.
Disciplines :
Cardiovascular & respiratory systems
Author, co-author :
Nagueh, S. F.; Methodist DeBakey Heart and Vascular Center, Center for Outcomes Research, Houston Methodist Research Institute, K.C.E.t.
Abraham, T. P.; Department of Medicine, University of Massachusetts Medical School, United Kingdom, Division of Cardiology, University of California at San Francisco (T.P.A.
Aurigemma, G. P.
Bax, J. J.; Department of Cardiology, Leiden University Medical CenterV.D, Switzerland
Beladan, Carmen C.; University of Medicine and Pharmacy "Carol Davila, Euroecolab, Institute of Cardiovascular Diseases, Bucharest, Romania
Browning, A.; Division of Cardiology, University of California at San Francisco (T.P.A.
Chamsi-Pasha, M. A.; Methodist DeBakey Heart and Vascular Center, Center for Outcomes Research, Houston Methodist Research Institute, K.C.E.t.
Delgado, V.; Department of Cardiology, Leiden University Medical CenterV.D, Switzerland
Derumeaux, G.; Physiology Department, DHU Ageing-Thorax-Vessel-Blood, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France
Dolci, G.; Department of Cardiology, Leiden University Medical CenterV.D, Switzerland
Donal, Erwan; Service de Cardiologie et Maladies Vasculaires, LTSI INSERM 1099, Universite Rennes-1, CHU Rennes
Edvardsen, Thor; University of Oslo, Germany
El Tallawi, K. C.; Methodist DeBakey Heart and Vascular Center, Center for Outcomes Research, Houston Methodist Research Institute, K.C.E.t.
Ernande, L.; Physiology Department, DHU Ageing-Thorax-Vessel-Blood, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France
Esposito, R.; Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
Flachskampf, Frank; Department of Medical Sciences, Uppsala University, Clinical Physiology and CardiologyUppsala, Sweden
Galderisi, Maurizio; Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
Gentry, J.; Cleveland Clinic, S.C.H.
Goldstein, S. A.; Department of Cardiology, MedStar Heart and Vascular InstituteWA, United States
Harb, S. C.; Cleveland Clinic, S.C.H.
Hubert, Arnaud
Hung, J.; Division of Cardiology, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, Australia
Klein, A. L.; Cleveland Clinic, S.C.H.
Lancellotti, Patrizio ; Université de Liège - ULiège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation
Mahmood, R. Z.; Department of Cardiology, MedStar Heart and Vascular InstituteWA, United States
Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure
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