Feasibility and Reproducibility of Contemporary Diastolic Parameters and
Classification
Abstract
Aims To evaluate the feasibility, time consumption, intra- and
inter-observer re-test reproducibility of echocardiographic indexes and
classification algorithms of diastolic function. Methods A total of 356
patients were examined prior to coronary artery by-pass grafting and/or
aortic valve replacement surgery. A subgroup of 50 were examined with 3
successive echocardiograms in conditions reflecting daily clinical
practice. Diastolic parameters suggested by former (2009) and current
(2016) guidelines were obtained and analysed. Acquisition and analysis
time, plus intra- and inter-observer variability were assessed. Results
Most of the parameters’ feasibility were between 93 and 99%, except the
TR Vmax (65%). Mean acquisition and analysis time were highest for the
left atrial volume (141±24 seconds), in contrast to other parameters
which were obtained in approximately one minute. 368 and 360 seconds was
in average needed to classify according to the 2009 and 2016 algorithms,
respectively (NS). The overall reproducibility was moderate (CV between
10-35%), with TR Vmax having lowest (CV 9.9-12%) and E/e’ the highest
(CV 22-35%) variation. The 2009 algorithm resulted in higher
indeterminate cases vs. the 2016 algorithm. Comparing the old and recent
guidelines, 20 and 8 patients were reclassified during inter-examiner
analysis, respectively. Conclusion The diastolic parameters are, in
general, feasible and time efficient. Reproducibility is moderate. The
2016 guidelines algorithm seemed superior to the 2009 algorithm in terms
of its feasibility and precision to classify patients in a uniform
matter. Time consumption was equal. The 2016 algorithm proved more
restrictive than 2009 in classifying patients with advanced stages of
DD.