Precision of Echocardiographic Measurements

Echocardiography is the most commonly used imaging modality for quantifying cardiovascular structural and hemodynamic parameters. The swiftness of acquisition coupled with the noninvasive nature of echocardiography enables evaluation of cardiac pathology over time—a practice that has become the norm in modern cardiology. Despite society guidelines standardizing echocardiographic image acquisition and interpretation, there still remains a degree of natural variation in common measurements due to loading parameters, image quality, acquisition differences, interobserver variability, and subclinical disease progression. 1 Mitchell C. Rahko P.S. Blauwet L.A. et al. Guidelines for performing a comprehensive transthoracic echocardiographic examination in adults: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2019; 32: 1-64 Abstract Full Text Full Text PDF PubMed Scopus (1216) Google Scholar However, evaluation of the variability in echocardiographic measurements has thus far only been performed in small, controlled cohorts—with limited assessment in clinical practice with real-world evidence. 2 Otterstad J.E. Froeland G. St John Sutton M. et al. Accuracy and reproducibility of biplane two-dimensional echocardiographic measurements of left ventricular dimensions and function. Eur Heart J. 1997; 18: 507-513 Crossref PubMed Scopus (317) Google Scholar , 3 Robson S.C. Murray A. Peart I. et al. Reproducibility of cardiac output measurement by cross sectional and Doppler echocardiography. Br Heart J. 1988; 59: 680-684 Crossref PubMed Scopus (55) Google Scholar , 4 Thorstensen A. Dalen H. Amundsen B.H. et al. Reproducibility in echocardiographic assessment of the left ventricular global and regional function, the HUNT study. Eur J Echocardiogr. 2010; 11: 149-156 Crossref PubMed Scopus (111) Google Scholar In this study, we characterized the precision of common echocardiographic parameters using the assumption that analysis of paired studies with "no significant change" would provide a basis to identify the variation in common echocardiographic measures and calculations.