Journal of the American Society of Echocardiography
Volume 23, Issue 3 , Pages 258-264, March 2010

Reliability of Visual Assessment of Global and Segmental Left Ventricular Function: A Multicenter Study by the Israeli Echocardiography Research Group

  • David S. Blondheim, MD

      Affiliations

    • Hillel-Yaffe Medical Center, Hadera, Israel
    • Corresponding Author InformationReprint requests: David S. Blondheim, MD, Hillel Yaffe Medical Center, Hadera, Israel.
    • ,
  • Ronen Beeri, MD

      Affiliations

    • Hadassah University Hospital, Jerusalem, Israel
    • ,
  • Micha S. Feinberg, MD

      Affiliations

    • Sheba Medical Center, Tel Aviv, Israel
    • ,
  • Mordehay Vaturi, MD

      Affiliations

    • Rabin Medical Center, Petah Tikva, Israel
    • ,
  • Sarah Shimoni, MD

      Affiliations

    • Kaplan Medical Center, Rehovot, Israel
    • ,
  • Wolfgang Fehske, MD

      Affiliations

    • St Vinzenz Hospital, Cologne, Germany
    • ,
  • Alik Sagie, MD

      Affiliations

    • Rabin Medical Center, Petah Tikva, Israel
    • ,
  • David Rosenmann, MD

      Affiliations

    • Shaare Zedek Medical Center, Jerusalem, Israel
    • ,
  • Peter Lysyansky, PhD

      Affiliations

    • GE Healthcare, Haifa, Israel
    • ,
  • Lisa Deutsch, PhD

      Affiliations

    • GE Healthcare, Haifa, Israel
    • ,
  • Marina Leitman, MD

      Affiliations

    • Assaf Harofeh Medical Center, Zerifin, Israel
    • ,
  • Rafael Kuperstein, MD

      Affiliations

    • Sheba Medical Center, Tel Aviv, Israel
    • ,
  • Ilan Hay, MD

      Affiliations

    • Sheba Medical Center, Tel Aviv, Israel
    • ,
  • Dan Gilon, MD

      Affiliations

    • Hadassah University Hospital, Jerusalem, Israel
    • ,
  • Zvi Friedman, PhD

      Affiliations

    • GE Healthcare, Haifa, Israel
    • ,
  • Yoram Agmon, MD

      Affiliations

    • Rambam Medical Center, Haifa, Israel
    • ,
  • Yossi Tsadok, BSc

      Affiliations

    • Ben-Gurion University, Beer Sheva, Israel
    • ,
  • Noah Liel-Cohen, MD

      Affiliations

    • Soroka University Medical Center, Beer Sheva, Israel

published online 08 February 2010.

Background

The purpose of this multicenter study was to determine the reliability of visual assessments of segmental wall motion (WM) abnormalities and global left ventricular function among highly experienced echocardiographers using contemporary echocardiographic technology in patients with a variety of cardiac conditions.

Methods

The reliability of visual determinations of left ventricular WM and global function was calculated from assessments made by 12 experienced echocardiographers on 105 echocardiograms recorded using contemporary echocardiographic equipment. Ten studies were reread independently to determine intraobserver reliability.

Results

Interobserver reliability for visual differentiation between normal, hypokinetic, and akinetic segments had an intraclass correlation coefficient of 0.70. The intraclass correlation coefficient for dichotomizing segments into normal versus other abnormal was 0.63, for hypokinetic versus other scores was 0.26, and for akinetic versus other scores was 0.58. Similar results were found for intraobserver reliability. Interobserver reliability for WM score index was 0.84 and for left ventricular ejection fraction was 0.78. Similar values were obtained for the intraobserver reliability of WM score index and ejection fraction. Compared to angiographic data, the accuracy of segmental WM assessments was 85%, and correct determination of the culprit artery was achieved in 59% of patients with myocardial infarctions.

Conclusion

Among experienced readers using contemporary echocardiographic equipment, interobserver and intraobserver reliability was reasonable for the visual quantification of normal and akinetic segments but poor for hypokinetic segments. Reliability was good for the visual assessment of global left ventricular function by WM score index and ejection fraction.

Keywords: Echocardiography, Variability, Reliability, Wall motion, Ejection fraction

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 Conflicts of interest: Drs Lysyansky and Friedman work for GE Healthcare and are involved in developing echocardiography software for the automatic detection and quantification of left ventricular wall motion abnormalities and function.

PII: S0894-7317(09)01206-1

doi:10.1016/j.echo.2009.12.020

Journal of the American Society of Echocardiography
Volume 23, Issue 3 , Pages 258-264, March 2010

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