Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients: The RES trial

Giovanni De Simone, M. Lorenza Muiesan, Antonello Ganau, Carlo Longhini, Paolo Verdecchia, Vittorio Palmieri, Enrico Agabiti-Rosei, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

Objective. To investigate the clinical reliability of repeated measurements of left ventricular mass in a single patient. Design. We used test-retest reliability analysis, within-class correlation and interval of agreement measures. Methods. Two M-mode tracings (three consecutive cycles) were recorded in the same session and 3-10 days apart (5 ± 2 days; mean ± SD) in 261 participants (age 45 ± 13 years, body mass index 24.7 ± 3.6 kg/m2; 131 hypertensive and 130 normotensive; 50% of each group women) in 16 centres in Italy. The two tracings were read by two observers in each centre, after classification by a three-order quality score (1 = poor, 2 = sufficient, 3 = optimal). Results. The average quality score was 2.11 ± 0.71 (21% poor, 50% sufficient, 29% optimal). Left ventricular mass values ranged from 56 to 419 g (170 ± 61 g). On the same day, within-observer 90% interval of agreement between tracing 1 and tracing 2 was -28 to +22 g (-17 to +11% of tracing 1). For day-to-day test-retest within-observer variability (average three cycles), the 90% interval of agreement was -30 to +35 g (-18 to +18%). This variability decreased to -13 to +12% at the 80% interval of agreement and -12 to +11% at the 75% interval of agreement. The 90% interval of agreement of test-retest between-observer variability was -26 to 30 g (-19 to +15%). A negligible regression toward the mean was identified. Categorical consistency of retest in the identification of hypertensive patients with left ventricular hypertrophy, classified in the first study, was 87% (k = 0.87). Conclusions. Measurement of left ventricular mass in single patients allows reliable risk stratification on the basis of the presence of left ventricular hypertrophy. The probability of a true change in left ventricular mass over time is maximized for a single-reader difference greater than 18% of the initial value, although differences of 10-13% might also have clinical relevance. (C) Lippincott Williams and Wilkins.

Original languageEnglish
Pages (from-to)1955-1963
Number of pages9
JournalJournal of Hypertension
Volume17
Issue number12 SUPPL.
Publication statusPublished - 1999

Fingerprint

Left Ventricular Hypertrophy
Reproducibility of Results
Italy
Body Mass Index

Keywords

  • Arterial hypertension
  • Cardiac hypertrophy
  • Cardiovascular risk
  • Variability

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology

Cite this

De Simone, G., Muiesan, M. L., Ganau, A., Longhini, C., Verdecchia, P., Palmieri, V., ... Mancia, G. (1999). Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients: The RES trial. Journal of Hypertension, 17(12 SUPPL.), 1955-1963.

Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients : The RES trial. / De Simone, Giovanni; Muiesan, M. Lorenza; Ganau, Antonello; Longhini, Carlo; Verdecchia, Paolo; Palmieri, Vittorio; Agabiti-Rosei, Enrico; Mancia, Giuseppe.

In: Journal of Hypertension, Vol. 17, No. 12 SUPPL., 1999, p. 1955-1963.

Research output: Contribution to journalArticle

De Simone, G, Muiesan, ML, Ganau, A, Longhini, C, Verdecchia, P, Palmieri, V, Agabiti-Rosei, E & Mancia, G 1999, 'Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients: The RES trial', Journal of Hypertension, vol. 17, no. 12 SUPPL., pp. 1955-1963.
De Simone, Giovanni ; Muiesan, M. Lorenza ; Ganau, Antonello ; Longhini, Carlo ; Verdecchia, Paolo ; Palmieri, Vittorio ; Agabiti-Rosei, Enrico ; Mancia, Giuseppe. / Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients : The RES trial. In: Journal of Hypertension. 1999 ; Vol. 17, No. 12 SUPPL. pp. 1955-1963.
@article{17538b659c2d4cf7b92424a7d1087f35,
title = "Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients: The RES trial",
abstract = "Objective. To investigate the clinical reliability of repeated measurements of left ventricular mass in a single patient. Design. We used test-retest reliability analysis, within-class correlation and interval of agreement measures. Methods. Two M-mode tracings (three consecutive cycles) were recorded in the same session and 3-10 days apart (5 ± 2 days; mean ± SD) in 261 participants (age 45 ± 13 years, body mass index 24.7 ± 3.6 kg/m2; 131 hypertensive and 130 normotensive; 50{\%} of each group women) in 16 centres in Italy. The two tracings were read by two observers in each centre, after classification by a three-order quality score (1 = poor, 2 = sufficient, 3 = optimal). Results. The average quality score was 2.11 ± 0.71 (21{\%} poor, 50{\%} sufficient, 29{\%} optimal). Left ventricular mass values ranged from 56 to 419 g (170 ± 61 g). On the same day, within-observer 90{\%} interval of agreement between tracing 1 and tracing 2 was -28 to +22 g (-17 to +11{\%} of tracing 1). For day-to-day test-retest within-observer variability (average three cycles), the 90{\%} interval of agreement was -30 to +35 g (-18 to +18{\%}). This variability decreased to -13 to +12{\%} at the 80{\%} interval of agreement and -12 to +11{\%} at the 75{\%} interval of agreement. The 90{\%} interval of agreement of test-retest between-observer variability was -26 to 30 g (-19 to +15{\%}). A negligible regression toward the mean was identified. Categorical consistency of retest in the identification of hypertensive patients with left ventricular hypertrophy, classified in the first study, was 87{\%} (k = 0.87). Conclusions. Measurement of left ventricular mass in single patients allows reliable risk stratification on the basis of the presence of left ventricular hypertrophy. The probability of a true change in left ventricular mass over time is maximized for a single-reader difference greater than 18{\%} of the initial value, although differences of 10-13{\%} might also have clinical relevance. (C) Lippincott Williams and Wilkins.",
keywords = "Arterial hypertension, Cardiac hypertrophy, Cardiovascular risk, Variability",
author = "{De Simone}, Giovanni and Muiesan, {M. Lorenza} and Antonello Ganau and Carlo Longhini and Paolo Verdecchia and Vittorio Palmieri and Enrico Agabiti-Rosei and Giuseppe Mancia",
year = "1999",
language = "English",
volume = "17",
pages = "1955--1963",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "12 SUPPL.",

}

TY - JOUR

T1 - Reliability and limitations of echocardiographic measurement of left ventricular mass for risk stratification and follow-up in single patients

T2 - The RES trial

AU - De Simone, Giovanni

AU - Muiesan, M. Lorenza

AU - Ganau, Antonello

AU - Longhini, Carlo

AU - Verdecchia, Paolo

AU - Palmieri, Vittorio

AU - Agabiti-Rosei, Enrico

AU - Mancia, Giuseppe

PY - 1999

Y1 - 1999

N2 - Objective. To investigate the clinical reliability of repeated measurements of left ventricular mass in a single patient. Design. We used test-retest reliability analysis, within-class correlation and interval of agreement measures. Methods. Two M-mode tracings (three consecutive cycles) were recorded in the same session and 3-10 days apart (5 ± 2 days; mean ± SD) in 261 participants (age 45 ± 13 years, body mass index 24.7 ± 3.6 kg/m2; 131 hypertensive and 130 normotensive; 50% of each group women) in 16 centres in Italy. The two tracings were read by two observers in each centre, after classification by a three-order quality score (1 = poor, 2 = sufficient, 3 = optimal). Results. The average quality score was 2.11 ± 0.71 (21% poor, 50% sufficient, 29% optimal). Left ventricular mass values ranged from 56 to 419 g (170 ± 61 g). On the same day, within-observer 90% interval of agreement between tracing 1 and tracing 2 was -28 to +22 g (-17 to +11% of tracing 1). For day-to-day test-retest within-observer variability (average three cycles), the 90% interval of agreement was -30 to +35 g (-18 to +18%). This variability decreased to -13 to +12% at the 80% interval of agreement and -12 to +11% at the 75% interval of agreement. The 90% interval of agreement of test-retest between-observer variability was -26 to 30 g (-19 to +15%). A negligible regression toward the mean was identified. Categorical consistency of retest in the identification of hypertensive patients with left ventricular hypertrophy, classified in the first study, was 87% (k = 0.87). Conclusions. Measurement of left ventricular mass in single patients allows reliable risk stratification on the basis of the presence of left ventricular hypertrophy. The probability of a true change in left ventricular mass over time is maximized for a single-reader difference greater than 18% of the initial value, although differences of 10-13% might also have clinical relevance. (C) Lippincott Williams and Wilkins.

AB - Objective. To investigate the clinical reliability of repeated measurements of left ventricular mass in a single patient. Design. We used test-retest reliability analysis, within-class correlation and interval of agreement measures. Methods. Two M-mode tracings (three consecutive cycles) were recorded in the same session and 3-10 days apart (5 ± 2 days; mean ± SD) in 261 participants (age 45 ± 13 years, body mass index 24.7 ± 3.6 kg/m2; 131 hypertensive and 130 normotensive; 50% of each group women) in 16 centres in Italy. The two tracings were read by two observers in each centre, after classification by a three-order quality score (1 = poor, 2 = sufficient, 3 = optimal). Results. The average quality score was 2.11 ± 0.71 (21% poor, 50% sufficient, 29% optimal). Left ventricular mass values ranged from 56 to 419 g (170 ± 61 g). On the same day, within-observer 90% interval of agreement between tracing 1 and tracing 2 was -28 to +22 g (-17 to +11% of tracing 1). For day-to-day test-retest within-observer variability (average three cycles), the 90% interval of agreement was -30 to +35 g (-18 to +18%). This variability decreased to -13 to +12% at the 80% interval of agreement and -12 to +11% at the 75% interval of agreement. The 90% interval of agreement of test-retest between-observer variability was -26 to 30 g (-19 to +15%). A negligible regression toward the mean was identified. Categorical consistency of retest in the identification of hypertensive patients with left ventricular hypertrophy, classified in the first study, was 87% (k = 0.87). Conclusions. Measurement of left ventricular mass in single patients allows reliable risk stratification on the basis of the presence of left ventricular hypertrophy. The probability of a true change in left ventricular mass over time is maximized for a single-reader difference greater than 18% of the initial value, although differences of 10-13% might also have clinical relevance. (C) Lippincott Williams and Wilkins.

KW - Arterial hypertension

KW - Cardiac hypertrophy

KW - Cardiovascular risk

KW - Variability

UR - http://www.scopus.com/inward/record.url?scp=0033506642&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033506642&partnerID=8YFLogxK

M3 - Article

C2 - 10703895

AN - SCOPUS:0033506642

VL - 17

SP - 1955

EP - 1963

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 12 SUPPL.

ER -