Interobserver and intraobserver variation for analysis of left ventricular wall motion at baseline and during low- and high-dose dobutamine stress echocardiography in patients with high prevalence of wall motion abnormalities at rest.

Interobserver and intraobserver variation for analysis of left ventricular regional wall motion during dobutamine stress echocardiography was assessed. Computer-displayed cineloops from 33 patients, 25 with baseline wall motion abnormalities, were analyzed by two observers blinded for patient data. Assessment included (1) baseline wall motion abnormalities, (2) evidence of myocardial viability at 10 micrograms/kg/min dobutamine, and (3) evidence of myocardial ischemia at 30 to 40 micrograms/kg/min. Wall motion score index was calculated at each stage. Interobserver and intraobserver agreement for baseline wall motion abnormalities was 100%. Interobserver agreement for viability and ischemia was 84% and 82%, respectively; intraobserver agreement was 92% and 85%, respectively. Mean interobserver differences in wall motion score index ranged from 0.06 +/- 0.14 at baseline to 0.09 +/- 0.20 at high doses (p < 0.05 at all levels); mean intraobserver differences ranged from 0.001 +/- 0.14 to 0.01 +/- 0.15 (difference not significant at all levels).