INTRAOBSERVER AND INTEROBSERVER REPRODUCIBILITY OF DOPPLER-ASSESSED INDEXES OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN A POPULATION-BASED STUDY (THE FRAMINGHAM HEART-STUDY)

被引:67
作者
GALDERISI, M
BENJAMIN, EJ
EVANS, JC
DAGOSTINO, RB
FULLER, DL
LEHMAN, B
WOLF, PA
LEVY, D
机构
[1] BOSTON CITY HOSP, DEPT CARDIOL, FRAMINGHAM HEART STUDY, 5 THURBER ST, FRAMINGHAM, MA 01701 USA
[2] BOSTON UNIV, DEPT MATH, BOSTON, MA 02215 USA
[3] BOSTON UNIV, SCH MED, DEPT NEUROL, BOSTON, MA 02118 USA
[4] BOSTON UNIV, SCH MED, DEPT PREVENT MED, BOSTON, MA 02118 USA
[5] BETH ISRAEL HOSP, DIV CARDIOL & CLIN EPIDEMIOL, BOSTON, MA 02215 USA
[6] NHLBI, BETHESDA, MD 20892 USA
[7] NAPLES UNIV, SCH MED 2, I-80138 NAPLES, ITALY
关键词
D O I
10.1016/0002-9149(92)90772-Q
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The reproducibility of a variety of Doppler indexes of diastolic function in an epidemiologic setting and in atrial fibrillation have not been reported. This study examined the reproducibility of left ventricular inflow in subjects in sinus rhythm (n = 80) and atrial fibrillation (n = 12), randomly selected from the original cohort of the Framing-ham Heart Study. The following Doppler indexes were assessed for all subjects: peak and integral of early (E) diastolic inflow velocity, acceleration slope and time, deceleration slope and time, and pressure half-time. For subjects in sinus rhythm, the following parameters also were measured: the peak and integral of late (A) diastolic inflow velocity, ratios of peak velocities and integrals E/A, and atrial filling fraction. Intraobserver and interobserver variability were evaluated by statistical methods including Student's t test of the systematic differences (bias), percent bias, correlation coefficients, measurement precision, and percent precision. In subjects in sinus rhythm, although the interobserver blas was statistically significant for most of the parameters, it was <10% for all but 1 parameter (acceleration time). For the peak and integral measures, the intra- and interobserver correlations were greater-than-or-equal-to 0.89, with intra- and interobserver percent precision measures within 2.2 to 13.0% of the corresponding mean values. The acceleration, deceleration and pressure half-time measures had somewhat lower correlations (interobserver correlations ranging from 0.59 to 0.96), with percent precision measures further from the corresponding means (interobserver percent precision ranging from 10.1 to 19.5%). The analyses of subjects with atrial fibrillation showed similar trends, despite the biologic (cycle-to-cycle) variability intrinsic to this arrhythmia. In conclusion, in an epidemiologic setting, the majority of Doppler indexes of diastolic function demonstrate excellent measurement reproducibility, especially the peak and time velocity integral measurements. Measurement variability may limit the reproducibility of early diastolic acceleration and deceleration parameters.
引用
收藏
页码:1341 / 1346
页数:6
相关论文
共 20 条
[1]   RELATION OF TRANSMITRAL FLOW VELOCITY PATTERNS TO LEFT-VENTRICULAR DIASTOLIC FUNCTION - NEW INSIGHTS FROM A COMBINED HEMODYNAMIC AND DOPPLER ECHOCARDIOGRAPHIC STUDY [J].
APPLETON, CP ;
HATLE, LK ;
POPP, RL .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1988, 12 (02) :426-440
[2]   DETERMINANTS OF DOPPLER INDEXES OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN NORMAL SUBJECTS (THE FRAMINGHAM HEART-STUDY) [J].
BENJAMIN, EJ ;
LEVY, D ;
ANDERSON, KM ;
WOLF, PA ;
PLEHN, JF ;
EVANS, JC ;
COMAI, K ;
FULLER, DL ;
SUTTON, MS .
AMERICAN JOURNAL OF CARDIOLOGY, 1992, 70 (04) :508-515
[3]  
BESSEN M, 1990, Cardiology Clinics, V8, P315
[4]  
DAWBER TR, 1951, AM J PUBLIC HEALTH, V41, P279
[5]   AN APPROACH TO LONGITUDINAL STUDIES IN A COMMUNITY - FRAMINGHAM STUDY [J].
DAWBER, TR ;
KANNEL, WB ;
LYELL, LP .
ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1963, 107 (02) :539-&
[6]  
Gardin J M, 1992, J Am Soc Echocardiogr, V5, P63
[7]  
GARDIN JM, 1987, AM J NONINVAS CARD, P13
[8]   EFFECT OF HEART-RATE ON LEFT-VENTRICULAR DIASTOLIC TRANSMITRAL FLOW VELOCITY PATTERNS ASSESSED BY DOPPLER ECHOCARDIOGRAPHY IN NORMAL SUBJECTS [J].
HARRISON, MR ;
CLIFTON, GD ;
PENNELL, AT ;
DEMARIA, AN ;
CATER, A .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 67 (07) :622-627
[9]  
Kuecherer H F, 1991, J Am Soc Echocardiogr, V4, P203
[10]   ASSESSMENT OF DIASTOLIC FUNCTION OF THE HEART - BACKGROUND AND CURRENT APPLICATIONS OF DOPPLER ECHOCARDIOGRAPHY .2. CLINICAL-STUDIES [J].
NISHIMURA, RA ;
ABEL, MD ;
HATLE, LK ;
TAJIK, AJ .
MAYO CLINIC PROCEEDINGS, 1989, 64 (02) :181-204