title: Test-retest variability of volumetric right ventricular measurements using real-time three-dimensional echocardiography.
abstract: BACKGROUND
  Substantial variability in sequential echocardiographic right ventricular (RV) quantification may exist. Interobserver and intraobserver values are well known, but acquisition (test-retest) variability has been rarely assessed. The objective of this study was to determine the test-retest variability of sequential RV volume and ejection fraction (EF) measurements by real-time three-dimensional echocardiography in patients with congenital heart disease and healthy controls.
  
  
  METHODS
  Twenty-eight participants (21 patients with congenital heart disease, seven healthy controls; mean age, 30 ± 14 years; 43% men) underwent a series of three echocardiographic studies. To obtain interobserver and intraobserver test-retest variability, two sonographers acquired sequential RV data sets in each participant during one outpatient visit. RV volumetric quantification was done using semiautomated three-dimensional border detection. The variability data were analyzed using correlation coefficients, Bland-Altman analysis, and coefficients of variation.
  
  
  RESULTS
  Absolute mean differences for sequential intraobserver acquisitions were 12 ± 12 mL for end-diastolic volume, 7 ± 6 mL for end-systolic volume, and 4 ± 3% for EF. Interobserver and intraobserver test-retest variability, respectively, were 7% and 7% for RV end-diastolic volume, 14% and 7% for end-systolic volume, and 8% and 6% for EF.
  
  
  CONCLUSIONS
  Good test-retest variability, besides the practical nature of real-time three-dimensional echocardiography for RV volume and EF assessment, makes it a valuable technique for serial follow-up. Although it may be challenging to diminish all factors that can influence echocardiographic examination for serial follow-up, standardization of RV size and functional measurements should be a goal to produce more interchangeable data.
authors: Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, ’s Gravendijkwal 230, Rotterdam, The Netherlands. h.vanderzwaan@erasmusmc.nl
authors: Heleen B
authors: HB
authors: van der Zwaan
authors: Marcel L
authors: ML
authors: Geleijnse
authors: Osama I I
authors: OI
authors: Soliman
authors: Jackie S
authors: JS
authors: McGhie
authors: Ellen J A
authors: EJ
authors: Wiegers-Groeneweg
authors: Willem A
authors: WA
authors: Helbing
authors: Jolien W
authors: JW
authors: Roos-Hesselink
authors: Folkert J
authors: FJ
authors: Meijboom
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D015203:Reproducibility of Results; D013318:Stroke Volume; D018497:Ventricular Dysfunction, Right / Q000151:congenital / Q000000981:diagnostic imaging* / Q000503:physiopathology