title: Reproducibility in echocardiographic assessment of diastolic function in a population based study (the STANISLAS Cohort study).
abstract: BACKGROUND
  There is limited evidence regarding intra-observer and inter-observer variations in echocardiographic measurements of diastolic function. This study aimed to assess this reproducibly within a population-based cohort study.
  
  
  METHODS
  Sixty subjects in sinus rhythm were randomly selected among 4th visit participants of the STANISLAS Cohort (Lorraine region, France). This 4th examination systematically included M-mode, 2-dimensional, DTI and pulsed-wave Doppler echocardiograms. Reproducibility of variables was studied by intra-class correlation coefficients (ICC) and Bland Altman plots.
  
  
  RESULTS
  Our population was on average middle-aged (50 ± 14 y), overweight (BMI = 26 ± 6 kg/m2) and non-smoking (87%) with a quarter of the participants having self-declared hypertension or treated with anti-hypertensive medication(s). Intra-observer ICC were > 0.90 for all analyzed parameters except for left ventricular ejection fraction (LVEF) which was 0.89 (0.81-0.93). The mean relative intra-observer differences were small and limits of agreement of relative differences were narrow for all considered parameters (<5% and <15% respectively). Inter-observer ICC were > 0.90 for all analyzed parameters except for LVEF (ICC = 0.87) and both mitral and pulmonary A wave duration (0.83 and 0.73 respectively). The mean relative inter-observer differences were <5% for all parameters except for pulmonary A wave duration (mean difference = 6.5%). Limits of agreement of relative differences were narrow (<15%), except for mitral A wave duration and velocity (both <20%) as well as left ventricular mass and pulmonary A wave duration (both <30%). Intra-observer agreements with regard to the presence and severity of diastolic dysfunction were excellent (Kappa = 0.93 (0.83-1.00) and 0.88 (0.75-0.99), respectively).
  
  
  CONCLUSIONS
  In this validation study within the STANISLAS cohort, diastolic function echocardiographic parameters were found to be highly reproducible. Diastolic dysfunction consequently appears as a highly effective clinical and research tool.
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Zied
authors: Z
authors: Frikha
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Nicolas
authors: N
authors: Girerd
authors: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France.
authors: Olivier
authors: O
authors: Huttin
authors: Fédération de cardiologie, European Society of Hypertension Excellence Centre, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, Grande Rue de la Croix-Rousse, 69004 Lyon, France; Génomique fonctionnelle de l'hypertension artérielle, EA 4173, université Claude-Bernard Lyon 1, 69100 Villeurbanne, France; Hôpital Nord-Ouest, 69400 Villefranche-sur-Saône, France.
authors: Pierre Yves
authors: PY
authors: Courand
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Erwan
authors: E
authors: Bozec
authors: Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Centre Hospitalier Universitaire de Nancy, Nancy, France.
authors: Arnaud
authors: A
authors: Olivier
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Zohra
authors: Z
authors: Lamiral
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Faiez
authors: F
authors: Zannad
authors: INSERM, Centre d'Investigations Cliniques 9501, Université de Lorraine, CHU de Nancy, Institut Lorrain du cœur et des vaisseaux, Nancy, France.
authors: Patrick
authors: P
authors: Rossignol
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000502:physiology; D015331:Cohort Studies; D003971:Diastole / Q000502:physiology*; D004452:Echocardiography; D005260:Female; D005602:France; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents