Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-29T07:33:13.039Z Has data issue: false hasContentIssue false
  • English
  • Français

Reliability of echocardiographic measurements of left cardiac structures in healthy children

Published online by Cambridge University Press:  20 August 2009

Miranda J. J. Geelhoed ,
Sonja P. E. Snijders ,
Veronica E. Kleyburg-Linkers ,
Eric A. P. Steegers ,
Lennie van Osch-Gevers  and
Vincent W. V. Jaddoe
Miranda J. J. Geelhoed
Affiliation:
The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
Sonja P. E. Snijders
Affiliation:
The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
Veronica E. Kleyburg-Linkers
Affiliation:
The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
Eric A. P. Steegers
Affiliation:
Department of Obstetrics & Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands
Lennie van Osch-Gevers
Affiliation:
Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
Vincent W. V. Jaddoe*
Affiliation:
The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands
*
Correspondence to: V.W.V. Jaddoe, MD PhD, The Generation R Study Group (AE-006), Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands. Tel: +31 (0) 10 7044524; Fax: +31 (0) 10 7044645; E-mail: v.jaddoe@erasmusmc.nl
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Echocardiographic measurements are widely used as outcomes of different studies. The aim of this study was to assess intraobserver and interobserver reliability of echocardiographic measurements in healthy children.

Materials and methods

We studied 28 children, with a median age of 7.5 years, and inter-quartile range from 3 to 11 years. Intraobserver and interobserver reliability were assessed by repeated measurements of the diameters of the aortic root, the left atrium, and left ventricular end-diastolic structure. We also measured the ventricular end-diastolic septal thickness and the end-diastolic thickness of the left ventricular posterior wall. We calculated intraclass correlation coefficients, with corresponding 95% confidence intervals, and computed Bland and Altman plots, permitting us to derive limits of agreement plus or minus 2 standard deviations for the mean differences in cardiac measurements.

Results

We found high intraobserver and interobserver intraclass correlation coefficient, ranging from 0.91 for ventricular septal thickness, with 95% confidence intervals from 0.78 to 0.96, to 0.99 for the diameter of the aortic root, 95% confidence interval from 0.97 to 1.00. Limits of agreement in the Bland and Altman plots ranged from zero millimetres for left ventricular end-diastolic posterior wall thickness to 1.60 millimeters (6.3%) for left atrial diameter.

Conclusions

Our study demonstrated good repeatability and reproducibility for ultrasonic measurements of left cardiac structures in children, showing that values obtained for measurement of these structures in both clinical and epidemiological research projects can be confidently accepted.

Keywords

Cardiac dimensionsultrasoundchildrenintraobserver/interobserver variability
Type
Original Article
Information
Cardiology in the Young , Volume 19 , Issue 5 , October 2009 , pp. 494 - 500
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Schieken, RM. Measurement of left ventricular wall mass in pediatric populations. Hypertension 1987; 9: 1147–1152.Google Scholar
2. Wallerson, DC, Devereux, RB. Reproducibility of echocardiographic left ventricular measurements. Hypertension 1987; 9: 116–118.CrossRefGoogle ScholarPubMed
3. Lipshultz, SE, Easley, KA, Orav, EJ, et al. Reliability of multicenter pediatric echocardiographic measurements of left ventricular structure and function: the prospective P(2)C(2) HIV study. Circulation 2001; 104: 310–316.CrossRefGoogle Scholar
4. Dai, S, Ayres, NA, Harrist, RB, Bricker, JT, Labarthe, DR. Validity of echocardiographic measurement in an epidemiological study. Project HeartBeat! Hypertension 1999; 34: 236–241.CrossRefGoogle Scholar
5. Jaddoe, VW, Bakker, R, van Duijn, CM, et al. The Generation R Study Biobank: a resource for epidemiological studies in children and their parents. Eur J Epidemiol 2007; 22: 917–923.Google Scholar
6. Jaddoe, VW, van Duijn, CM, van der Heijden, AJ, et al. The Generation R Study: design and cohort update until the age of 4 years. Eur J Epidemiol 2008; 23: 801–811.Google Scholar
7. Schiller, NB, Shah, PM, Crawford, M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two-Dimensional Echocardiograms. J Am Soc Echocardiogr 1989; 2: 358–367.Google Scholar
8. Bland, JM, Altman, DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.CrossRefGoogle ScholarPubMed
9. Bland, JM, Altman, DG. Applying the right statistics: analyses of measurement studies. Ultrasound Obstet Gynecol 2003; 22: 85–93.Google Scholar
10. Sahn, DJ, DeMaria, A, Kisslo, J, Weyman, A. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072–1083.Google Scholar
11. Valdez, RS, Motta, JA, London, E, et al. Evaluation of the echocardiogram as an epidemiologic tool in an asymptomatic population. Circulation 1979; 60: 921–929.Google Scholar
12. Ladipo, GO, Dunn, FG, Pringle, TH, Bastian, B, Lawrie, TD. Serial measurements of left ventricular dimensions by echocardiography. Assessment of week-to-week, inter- and intraobserver variability in normal subjects and patients with valvular heart disease. Br Heart J 1980; 44: 284–289.CrossRefGoogle ScholarPubMed
13. Sargent, MA, Wilson, BP. Observer variability in the sonographic measurement of renal length in childhood. Clin Radiol 1992; 46: 344–347.CrossRefGoogle ScholarPubMed
14. Schlesinger, AE, Hernandez, RJ, Zerin, JM, Marks, TI, Kelsch, RC. Interobserver and intraobserver variations in sonographic renal length measurements in children. Am J Roentgenol 1991; 156: 1029–1032.CrossRefGoogle ScholarPubMed