Cited 15 times since 2019 (3.4 per year) source: EuropePMC Circulation. Cardiovascular imaging, Volume 12, Issue 1, 1 1 2019, Pages e008122 Interobserver Variability in Applying American Society of Echocardiography/European Association of Cardiovascular Imaging 2016 Guidelines for Estimation of Left Ventricular Filling Pressure. Nagueh SF, Abraham TP, Aurigemma GP, Bax JJ, Beladan C, Browning A, Chamsi-Pasha MA, Delgado V, Derumeaux G, Dolci G, Donal E, Edvardsen T, El Tallawi KC, Ernande L, Esposito R, Flachskampf FA, Galderisi M, Gentry J, Goldstein SA, Harb SC, Hubert A, Hung J, Klein AL, Lancellotti P, Mahmood RZ, Marino P, Popescu BA, Previato M, Sanghai SR, Smiseth OA, Xu J, for Diastolic Function Assessment Collaborators
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.
