REPRODUCIBILITY OF LEFT-VENTRICULAR VOLUMES BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
REPRODUCIBILITY OF LEFT-VENTRICULAR VOLUMES BY TWO-DIMENSIONAL ECHOCARDIOGRAPHY
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DOI：
10.1016/s0735-1097(83)80278-2
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发表时间：
1983-01-01
影响因子：
24
通讯作者：
POPP, RL
中科院分区：
文献类型：
--
作者：
GORDON, EP;SCHNITTGER, I;POPP, RL
在流行病学或生理学研究中，评价超声心动图左心室容积估计方法的实用性时，重复性与绝对准确性同样重要。在使用任何定量技术可靠地记录心脏容积随时间的真实的变化之前，必须确定同一受试者每天测量值之间的差异幅度。对30例受试者（包括20例正常人和10例稳定型冠心病患者）间隔数天进行二维超声心动图检查。光笔描记分析提供了舒张末期容积，收缩末期容积和导出射血分数的测量值，并对个体受试者在两天之间的差异进行了定量。还评估了心搏间、观察者间和观察者内变异性。虽然组值每天变化不大，但在某些情况下个体体积变化很大。个体测量值的置信限来自受试者内变异性分析，如下所示：舒张末期容积。15%，收缩末期容积。射血分数25%百分之十在更大的受试者群体中，置信限更窄。在一组30名受试者中，舒张末期容积变化> 2%、收缩末期容积变化5%和射血分数变化2%最可能代表真实的变化。观察者内变异性很小，但观察者间和心搏间变异性的幅度足以表明，理想情况下，由一个人对给定受试者进行连续测量，并对给定测量的几个周期进行平均。
Reproducibility may be as important as absolute accuracy in assessing the utility of an echocardiographic method of left ventricular volume estimation for epidemiologic or physiologic studies. The magnitude of differences between measurements in the same subjects from day to day must be defined before any quantitative technique can be used reliably to document real changes in heart volume over time. Two-dimensional echocardiograms were performed several days apart in 30 subjects, including 20 normal subjects and 10 patients with stable coronary heart disease. Analyses of light-pen tracings provided measurements of end-diastolic volume, endsystolic volume and derived ejection fraction on both days and differences in individual subjects between days were quantitated. Beat to beat, interobserver and intraobserver variability also were assessed. Although group values changed little from day to day, individual volume changes were substantial in some cases. Confidence limits for individual measurements were derived from analyses of intrasubject variability and were as follows: end-diastolic volume .+-. 15%, end-systolic volume .+-. 25%, ejection fraction .+-. 10%. Confidence limits in a larger group of subjects were narrower. In a group of 30 subjects, changes of > 2% in enddiastolic volume, 5% in end-systolic volume and 2% in ejection fraction most likely represent real change. Intraobserver variability was minimal, but interobserver and beat to beat variability were of sufficient magnitude to suggest that serial measurements on a given subject be made ideally by a single person and that several cycles be averaged for a given measurement.