Reliability of Multicenter Pediatric Echocardiographic Measurements of Left Ventricular Structure and Function: The Prospective P2C2 HIV Study

• Type of Material: Article
• Authors: Steven E. Lipshultz, University of Rochester; Kirk Easley, Emory University; E. John Orav, Brigham and Woman’s Hospital; Samuel Kaplan, University of California Los Angeles; Thomas J. Starc, Columbia University; J. Timothy Bricker, Columbia University; Wyman W. Lai, University of California Los Angeles; Douglas S. Moodie, Cleveland Clinic Foundation; George Sopko, Baylor College of Medicine; Mark D. Schluchter, Cleveland Clinic Foundation; Steven D. Colan, University of Rochester
• Language: English
• Date: 2001-07-17
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: ©2001 American Heart Association, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1161/01.CIR.104.3.310
• Title of Journal or Parent Work: Circulation
• ISSN: 0009-7322
• Volume: 104
• Issue: 3
• Start Page: 310
• End Page: 316
• Grant/Funding Information: This work was supported by the NHLBI (NO1-HR-96037, NO1-HR-96038, NO1-HR-96039, NO1-HR-96040, NO1-HR-96041, NO1-HR-96042, and NO1-HR-96043) and in part by the National Institutes of Health (RR-00865, RR-00188, RR-02172, RR-00533, RR-00071, RR-00645, RR-00685, and RR-00043).
• Keywords: pediatrics; echocardiography; AIDS
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background To assess the reliability of pediatric echocardiographic measurements, we compared local measurements with those made at a central facility. Methods and Results The comparison was based on the first echocardiographic recording obtained on 735 children of HIV-infected mothers at 10 clinical sites focusing on measurements of left ventricular (LV) dimension, wall thicknesses, and fractional shortening. The recordings were measured locally and then remeasured at a central facility. The highest agreement expressed as an intraclass correlation coefficient (ICC=0.97) was noted for LV dimension, with much lower agreement for posterior wall thickness (ICC=0.65), fractional shortening (ICC=0.64), and septal wall thickness (ICC=0.50). The mean dimension was 0.03 cm smaller in central measurements (95% prediction interval [PI], −0.32 to 0.25 cm) for which 95% PI reflects the magnitude of differences between local and central measurements. Mean posterior wall thickness was 0.02 cm larger in central measurements (95% PI, −0.18 to 0.22 cm). Mean fractional shortening was 1% smaller in central measurements. However, the 95% PI was −10% to 8%, indicating that a fractional shortening of 32% measured centrally could be anywhere between 22% and 40% when measured locally. Central measurements of mean septal thickness were ≈0.1 cm thicker than local ones (95% PI, −0.18 to 0.34 cm). Centrally measured wall thickness was more closely related to mortality and possibly was more valid than local measurements. Conclusions Although LV dimension was reliably measured, local measurements of LV wall thickness and fractional shortening differed from central measurements.