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A multicentric quality-control study of exercise Doppler echocardiography of the right heart and the pulmonary circulation
  • +27
  • Francesco Ferrara,
  • Luna Gargani,
  • Carla Contaldi,
  • Gergely Agoston,
  • Paola Argiento,
  • William Armstrong,
  • Rodolfo Citro,
  • Antonio Cittadini,
  • Rosangela Cocchia,
  • Michele D'Alto,
  • Antonello D'Andrea,
  • Philippe Douschan,
  • Stefano Ghio,
  • Ekkehard Grünig,
  • Marco Guazzi,
  • Jaroslaw Kasprzak,
  • Theodore Kolias,
  • Alberto Marra,
  • Antonella Moreo,
  • Francesco Pieri,
  • Lorenza Pratali,
  • Brigida Ranieri,
  • Lawrence Rudski,
  • Valentina Russo,
  • Rajan Saggar,
  • Anna Agnese Stanziola,
  • Mani A. Vannan,
  • Olga Vriz,
  • Robert Naeije,
  • Eduardo Bossone
Francesco Ferrara

Corresponding Author:[email protected]

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Luna Gargani
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Carla Contaldi
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Gergely Agoston
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Paola Argiento
Second University of Naples – Monaldi Hospital
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William Armstrong
University of Michigan
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Rodolfo Citro
A.O.U. San Giovanni di Dio e Ruggi d'Aragona
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Antonio Cittadini
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Rosangela Cocchia
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Michele D'Alto
Second University of Naples – Monaldi Hospital
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Antonello D'Andrea
Second University of Naples
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Philippe Douschan
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Stefano Ghio
Fondazione IRCCS Policlinico San Matteo
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Ekkehard Grünig
Thoraxclinic at the University Hospital Heidelberg
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Marco Guazzi
IRCCS
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Jaroslaw Kasprzak
Medical University of LodzII
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Theodore Kolias
University of Michigan
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Alberto Marra
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Antonella Moreo
Niguarda Cà Granda Hospital
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Francesco Pieri
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Lorenza Pratali
National Center of Research (CNR)
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Brigida Ranieri
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Lawrence Rudski
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Valentina Russo
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Rajan Saggar
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Anna Agnese Stanziola
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Mani A. Vannan
Ohio State Univ
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Olga Vriz
San Antonio Hospital
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Robert Naeije
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Eduardo Bossone
ASL Salerno
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Abstract

Purpose: This study was a quality-control study of resting and exercise echocardiography (EDE) variables measured by 19 echocardiography laboratories with proven experience participating in the RIGHT Heart International NETwork. Methods: All participating investigators reported the requested variables from ten randomly selected exercise stress tests. Intraclass correlation coefficients (ICC) were calculated to evaluate the inter-observer agreement with the core laboratory. Inter-observer variability of resting and peak exercise tricuspid regurgitation velocity (TRV), right ventricular outflow tract acceleration time (RVOT Act), tricuspid annular plane systolic excursion (TAPSE), tissue Doppler tricuspid lateral annular systolic velocity (S’), right ventricular fractional area change (RV FAC), left ventricular outflow tract velocity time integral (LVOT VTI), mitral inflow pulsed wave Doppler velocity (E), diastolic mitral annular velocity by TDI (e’) and left ventricular ejection fraction (LVEF) was measured. Results: The accuracy of 19 investigators for all variables ranged from 99.7% to 100%. ICC was > 0.80 for all observers. Inter-observer variability for resting and exercise variables was for TRV = 3.8 to 2.4%, E = 5.7 to 8.3%, e’ = 6 to 6.5%, RVOT Act = 9.7 to 12, LVOT VTI = 7.4 to 9.6%, S’= 2.9 to 2.9% and TAPSE = 5.3 to 8%. Moderate inter-observer variability was found for resting and peak exercise RV FAC (15 to 16%). LVEF revealed lower resting and peak exercise variability of 7.6 and 9%. Conclusions: When performed in expert centers EDE is a reproducible tool for the assessment of the right heart and the pulmonary circulation