BACKGROUND: Monitoring of the appearance of left ventricular hypertrophy (LVH) by echocardiography is currently recommended for in the management of children with End-stage renal disease (ESRD). In order to investigate the validity of this method in ESRD children, we assessed the intra- and inter-observer reproducibility of the diagnosis LVH. METHODS: Echocardiographic measurements in 92 children (0-18 years) with ESRD, made by original analysists, were reassessed offline, twice, by 3 independent observers. Smallest detectable changes (SDC) were calculated for continuous measurements of diastolic interventricular septum (IVSd), Left ventricle posterior wall thickness (LVPWd), Left ventricle end-diastolic diameter (LVEDd), and Left ventricle mass index (LVMI). Cohen's kappa was calculated to assess the reproducibility of LVH defined in two different ways. LVH(WT) was defined as Z-value of IVSd and/or LVPWd>2 and LVH(MI) was defined as LVMI> 103 g/m² for boys and >84 g/m² for girls. RESULTS: The intra-observer SDCs ranged from 1.6 to 1.7 mm, 2.0 to 2.6 mm and 17.7 to 30.5 g/m² for IVSd, LVPWd and LVMI, respectively. The inter-observer SDCs were 2.6 mm, 2.9 mm and 24.6 g/m² for IVSd, LVPWd and LVMI, respectively. Depending on the observer, the prevalence of LVH(WT) and LVH(MI) ranged from 2 to 30% and from 8 to 25%, respectively. Kappas ranged from 0.4 to 1.0 and from 0.1 to 0.5, for intra-and inter- observer reproducibility, respectively. CONCLUSIONS: Changes in diastolic wall thickness of less than 1.6 mm or LVMI less than 17.7 g/m² cannot be distinguished from measurement error in individual children, even when measured by the same observer. This limits the use of echocardiography to detect changes in wall thickness in children with ESRD in routine practice.
BACKGROUND: Monitoring of the appearance of left ventricular hypertrophy (LVH) by echocardiography is currently recommended for in the management of children with End-stage renal disease (ESRD). In order to investigate the validity of this method in ESRDchildren, we assessed the intra- and inter-observer reproducibility of the diagnosis LVH. METHODS: Echocardiographic measurements in 92 children (0-18 years) with ESRD, made by original analysists, were reassessed offline, twice, by 3 independent observers. Smallest detectable changes (SDC) were calculated for continuous measurements of diastolic interventricular septum (IVSd), Left ventricle posterior wall thickness (LVPWd), Left ventricle end-diastolic diameter (LVEDd), and Left ventricle mass index (LVMI). Cohen's kappa was calculated to assess the reproducibility of LVH defined in two different ways. LVH(WT) was defined as Z-value of IVSd and/or LVPWd>2 and LVH(MI) was defined as LVMI> 103 g/m² for boys and >84 g/m² for girls. RESULTS: The intra-observer SDCs ranged from 1.6 to 1.7 mm, 2.0 to 2.6 mm and 17.7 to 30.5 g/m² for IVSd, LVPWd and LVMI, respectively. The inter-observer SDCs were 2.6 mm, 2.9 mm and 24.6 g/m² for IVSd, LVPWd and LVMI, respectively. Depending on the observer, the prevalence of LVH(WT) and LVH(MI) ranged from 2 to 30% and from 8 to 25%, respectively. Kappas ranged from 0.4 to 1.0 and from 0.1 to 0.5, for intra-and inter- observer reproducibility, respectively. CONCLUSIONS: Changes in diastolic wall thickness of less than 1.6 mm or LVMI less than 17.7 g/m² cannot be distinguished from measurement error in individual children, even when measured by the same observer. This limits the use of echocardiography to detect changes in wall thickness in children with ESRD in routine practice.
Authors: John S Gottdiener; James Bednarz; Richard Devereux; Julius Gardin; Allan Klein; Warren J Manning; Annitta Morehead; Dalane Kitzman; Jae Oh; Miguel Quinones; Nelson B Schiller; James H Stein; Neil J Weissman Journal: J Am Soc Echocardiogr Date: 2004-10 Impact factor: 5.251
Authors: Jaap W Groothoff; Mariken P Gruppen; Martin Offringa; Jeroen Hutten; Marc R Lilien; Nicole J Van De Kar; Eric D Wolff; Jean Claude Davin; Hugo S A Heymans Journal: Kidney Int Date: 2002-02 Impact factor: 10.612
Authors: V Palmieri; B Dahlöf; V DeQuattro; N Sharpe; J N Bella; G de Simone; M Paranicas; D Fishman; R B Devereux Journal: J Am Coll Cardiol Date: 1999-11-01 Impact factor: 24.094
Authors: Giuliana G Repetti; Yuri Kim; Alexandre C Pereira; Jodie Ingles; Mark W Russell; Neal K Lakdawala; Carolyn Y Ho; Sharlene Day; Christopher Semsarian; Barbara McDonough; Steven R DePalma; Daniel Quiat; Eric M Green; Christine E Seidman; J G Seidman Journal: Proc Natl Acad Sci U S A Date: 2021-03-09 Impact factor: 12.779
Authors: Maciej Marciniak; Andrew Gilbert; Filip Loncaric; Joao Filipe Fernandes; Bart Bijnens; Marta Sitges; Andrew King; Fatima Crispi; Pablo Lamata Journal: J Hypertens Date: 2021-07-01 Impact factor: 4.776
Authors: Maike van Huis; Nikki J Schoenmaker; Jaap W Groothoff; Johanna H van der Lee; Maria van Dyk; Marc Gewillig; Linda Koster; Ronald Tanke; Marc Lilien; Nico A Blom; Luc Mertens; Irene M Kuipers Journal: Pediatr Nephrol Date: 2016-05-17 Impact factor: 3.714