title: Interobserver agreement on the echocardiographic parameters that estimate right ventricular systolic function in the early postoperative period of cardiac surgery.
abstract: OBJECTIVE
  To know the variability of transthoracic echocardiographic parameters that assess right ventricular systolic function by analyzing interobserver agreement in the early postoperative period of cardiovascular surgery.
  
  
  OBJECTIVE
  To assess the feasibility of these echocardiographic measurements.
  
  
  METHODS
  A cross-sectional study, double-blind pilot study was carried out from May 2011 to February 2013.
  
  
  METHODS
  Cardiovascular postoperative critical care at the National Institute of Cardiology "Ignacio Chávez", Mexico City, Mexico.
  
  
  METHODS
  Consecutive, non-probabilistic sampling. Fifty-six patients were studied in the postoperative period of cardiac surgery.
  
  
  METHODS
  The first echocardiographic parameters were obtained between 6-8hours after cardiac surgery, followed by blinded second measurements.
  
  
  METHODS
  Tricuspid annular plane systolic excursion (TAPSE), tricuspid annular peak systolic velocity on tissue Doppler imaging (VSPAT), diameters and right ventricular outflow area, tract fractional shortening. The agreement was analyzed by the Bland-Altman method, and its magnitude was assessed by the intraclass correlation coefficient (95% confidence interval).
  
  
  RESULTS
  Both observers evaluated TAPSE and VSPAT in 48 patients (92%). The average TAPSE was 11.68±4.53mm (range 4-27mm). Right ventricular systolic dysfunction was observed in 41 cases (85%) and normal TAPSE in 7 patients (15%). The average difference and its limits according to TAPSE were -0.917±2.95 (-6.821, 4.988), with a magnitude of 0.725 (0.552, 0.837); the tricuspid annular peak systolic velocity on tissue Doppler imaging was -0.001±0.015 (-0.031, 0.030), and its magnitude 0.825 (0.708, 0.898), respectively.
  
  
  CONCLUSIONS
  VSPAT and TAPSE were estimated by both observers in 92% of the patients, these parameters exhibiting the lowest interobserver variability.
authors.affiliation: Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Instituto Nacional de Cardiología «Ignacio Chávez», México D.F., México.
authors.forename: S G
authors.initials: SG
authors.lastname: Olmos-Temois
authors.affiliation: Unidad Médica de Alta Especialidad, Departamento de Hipertensión Pulmonar y Función Ventricular Derecha, Hospital de Cardiología del Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social , México D.F., México; Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Instituto Nacional de Cardiología «Ignacio Chávez», México D.F., México. Electronic address: luis.santosma@imss.gob.mx.
authors.forename: L E
authors.initials: LE
authors.lastname: Santos-Martínez
authors.affiliation: Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Instituto Nacional de Cardiología «Ignacio Chávez», México D.F., México.
authors.forename: R
authors.initials: R
authors.lastname: Álvarez-Álvarez
authors.affiliation: Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Instituto Nacional de Cardiología «Ignacio Chávez», México D.F., México.
authors.forename: L G
authors.initials: LG
authors.lastname: Gutiérrez-Delgado
authors.affiliation: Departamento de Cuidados Intensivos Posquirúrgicos Cardiovasculares, Instituto Nacional de Cardiología «Ignacio Chávez», México D.F., México.
authors.forename: F M
authors.initials: FM
authors.lastname: Baranda-Tovar
mesh_terms: D003430:Cross-Sectional Studies; D004311:Double-Blind Method; D004452:Echocardiography; D006801:Humans; D015588:Observer Variation; D010865:Pilot Projects; D014261:Tricuspid Valve; D018497:Ventricular Dysfunction, Right / Q000175:diagnosis*
keywords: Cardiac surgery; Cirugía cardiaca; Echocardiography; Ecocardiografía; Fiabilidad; Función del ventrículo derecho; Interobserver variability; Reliability; Right ventricular function; Variabilidad interobservador