title: Inter- and intra-observer variability in the echocardiographic evaluation of right ventricular function.
abstract: OBJECTIVE
  Echocardiographic evaluation of right ventricular systolic function remains subject to debate because of the anatomic peculiarities of the right ventricle. Several methods have been developed for quantifying right ventricular systolic function. The aim of this study was to determine the reliability and reproducibility of a number of echocardiographic parameters by evaluating their inter-observer and intra-observer variability.
  
  
  METHODS
  The study included 30 patients with isolated mitral valvulopathy scheduled for heart surgery. All underwent echocardiography, which was performed independently by two echocardiographers within 24 hours. The intra-observer analysis was carried out using the recorded images at least 1 month after they had been obtained. The parameters studied were the tricuspid annular plane systolic excursion (TAPSE), the tricuspid annular peak systolic velocity on tissue Doppler imaging, right ventricular outflow tract fractional shortening, fractional shortening of right ventricular diameters, and fractional shortening of right ventricular areas. Variability was analyzed using the intraclass correlation coefficient.
  
  
  RESULTS
  The degree of concordance on TAPSE and tricuspid annular peak systolic velocity measurement was good in the inter-observer analysis and excellent in the intra-observer analysis. However, concordance was poor on measurements of the fractional shortening of the right ventricular outflow tract, areas and diameters on both inter-observer and intra-observer analyses.
  
  
  CONCLUSIONS
  The most reliable and reproducible echocardiographic parameters for evaluating right ventricular systolic function in patients with isolated mitral valvulopathy were the TAPSE and the tricuspid annular peak systolic velocity.
authors.affiliation: Servicio de Cardiología y Cirugía Cardiaca, Instituto de Ciencias del Corazón (ICICOR), Hospital Clínico Universitario, Valladolid, Spain. mpinedog@gmail.com
authors.forename: Marta
authors.initials: M
authors.lastname: Pinedo
authors.forename: Eduardo
authors.initials: E
authors.lastname: Villacorta
authors.forename: Cristina
authors.initials: C
authors.lastname: Tapia
authors.forename: Roman
authors.initials: R
authors.lastname: Arnold
authors.forename: Javier
authors.initials: J
authors.lastname: López
authors.forename: Ana
authors.initials: A
authors.lastname: Revilla
authors.forename: Itziar
authors.initials: I
authors.lastname: Gómez
authors.forename: Enrique
authors.initials: E
authors.lastname: Fulquet
authors.forename: José A
authors.initials: JA
authors.lastname: San Román
mesh_terms: D000368:Aged; D004452:Echocardiography; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000601:surgery; D015588:Observer Variation; D015203:Reproducibility of Results; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis / Q000000981:diagnostic imaging; D016278:Ventricular Function, Right / Q000502:physiology*