Intra- and interobserver reproducibility of Doppler-assessed indexes of left ventricular diastolic function in a population-based study (the Framingham Heart Study).
Intra- and interobserver reproducibility of Doppler-assessed indexes of left ventricular diastolic function in a population-based study (the Framingham Heart Study).
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在一项基于人群的研究（弗雷明汉心脏研究）中，多普勒评估的左心室舒张功能指数的观察者内和观察者间再现性。
DOI：
10.1016/0002-9149(92)90772-q
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Levy,D
中科院分区：
文献类型：
--
作者：
Galderisi,M;Benjamin,EJ;Evans,JC;D'Agostino,RB;Fuller,DL;Lehman,B;Wolf,PA;Levy,D
各种多普勒舒张功能指数在流行病学背景下和房颤中的可重复性尚未报道。本研究检查了从Frachial Heart研究的原始队列中随机选择的窦性心律（n = 80）和房颤（n = 12）受试者的左心室流入的再现性。评估所有受试者的以下多普勒指标：舒张早期（E）血流速度峰值和积分、加速斜率和时间、减速斜率和时间以及压力半衰期。对于窦性心律的受试者，还测量了以下参数：舒张晚期（A）流入流速的峰值和积分，峰值流速和积分E/A的比值，以及心房充盈分数。通过统计学方法评价观察者内和观察者间变异性，包括系统差异（偏倚）的Student's f检验、偏倚百分比、相关系数、测量精密度和精密度百分比。在窦性心律受试者中，尽管大多数参数的观察者间偏倚具有统计学显著性，但除1个参数（加速时间）外，其他参数均<10%。对于峰值和积分测量值，观察者内和观察者间相关性≥ 0.89，观察者内和观察者间精密度百分比测量值在相应平均值的2.2%至13.0%范围内。加速、减速和压力减半时间测量值的相关性略低（观察者间相关性范围为0.59 - 0.96），精密度测量值百分比与相应平均值的相关性更低（观察者间精密度百分比范围为10.1 - 19.5%）。对房颤受试者的分析显示了相似的趋势，尽管这种心律失常具有固有的生物学（周期间）变异性。总之，在流行病学背景下，大多数舒张功能的多普勒指标表现出良好的测量重现性，特别是峰值和时间速度积分测量。测量变异性可能限制舒张早期加速和减速参数的再现性。
The reproducibility of a variety of Doppler indexes of diastolic function in an epidemiotogic setting and in atrial fibrillation have not been reported. This study examined the reproducibility of left ventricular inflow in subjects in sinus rhythm (n = 80) and atrial fibrillation (n = 12), randomly selected from the original cohort of the Framingham Heart Study. The following Doppler indexes were assessed for all subjects: peak and integral of early (E) diastolic inflow velocity, acceleration slope and time, deceleration slope and time, and pressure half-time. For subjects in sinus rhythm, the following parameters also were measured: the peak and integral of late (A) diastolic inflow velocity, ratios of peak velocities and integrals E/A, and atrial filling fraction. Intraobserver and interobserver variability were evaluated by statistical methods including Student's f test of the systematic differences (bias), percent bias, correlation coefficients, measurement precision, and percent precision. In subjects in sinus rhythm, although the interobserver bias was statistically significant for most of the parameters, it was <10% for all but 1 parameter (acceleration time). For the peak and integral measures, the intra- and interobserver correlations were ≥ 0.89, with intra- and interobserver percent precision measures within 2.2 to 13.0% of the corresponding mean values. The acceleration, deceleration and pressure half-time measures had somewhat lower correlations (interobserver correlations ranging from 0.59 to 0.96), with percent precision measures further from the corresponding means (interobserver percent precision ranging from 10.1 to 19.5%). The analyses of subjects with atrial fibrillation showed similar trends, despite the biologic (cycle-to-cycle) variability intrinsic to this arrhythmia. In conclusion, in an epidemiologic setting, the majority of Doppler indexes of diastolic function demonstrate excellent measurement reproducibility, especially the peak and time velocity integral measurements. Measurement variability may limit the reproducibility of early diastolic acceleration and deceleration parameters.