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CC BY 4.0 · TH Open 2024; 08(01): e1-e8
DOI: 10.1055/s-0043-1777765
Original Article

Validation of Echocardiographic Measurements in Patients with Pulmonary Embolism in the RIETE Registry

Mads Dam Lyhne 
1   Department of Anesthesiology and Intensive Care, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Behnood Bikdeli
2   Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
3   Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States
4   Yale-New Haven Hospital (YNHH)/Yale Center for Outcomes Research and Evaluation (CORE), New Haven, Connecticut, United States
,
David M. Dudzinski
5   Department of Cardiology, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Alfonso Muriel-García
6   Unidad de Bioestadística Clínica, Hospital Universitario Ramón y Cajal, Madrid and CIBERESP, Universidad de Alcalá, Madrid, Spain
,
Christopher Kabrhel
7   Department of Emergency Medicine, Centre of Vascular Emergencies, Massachusetts General Hospital, Boston, Massachusetts, United States
,
Teresa Sancho-Bueso
8   Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
,
Esther Pérez-David
9   Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
,
José Luis Lobo
10   Department of Pneumonology, Hospital Universitario Araba, Álava, Spain
,
Ángel Alonso-Gómez
11   Department of Cardiology, Hospital Universitario Araba, Álava, Spain
,
David Jiménez 
12   Respiratory Department, Hospital Ramón y Cajal and Medicine Department, Universidad de Alcalá, Madrid, Spain
13   CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
,
Manuel Monreal
13   CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain
14   Chair for the Study of Thromboembolic Disease, Faculty of Health Sciences, UCAM - Universidad Católica San Antonio de Murcia, Murcia, Spain
,
the RIETE Investigators › Author Affiliations Funding None.
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Abstract

Background In acute pulmonary embolism (PE), echocardiographic identification of right ventricular (RV) dysfunction will inform prognostication and clinical decision-making. Registro Informatizado Enfermedad TromboEmbolica (RIETE) is the world's largest registry of patients with objectively confirmed PE. The reliability of site-reported RV echocardiographic measurements is unknown. We aimed to validate site-reported key RV echocardiographic measurements in the RIETE registry.

Methods Fifty-one randomly chosen patients in RIETE who had transthoracic echocardiogram (TTE) performed for acute PE were included. TTEs were de-identified and analyzed by a core laboratory of two independent observers blinded to site-reported data. To investigate reliability, intraclass correlation coefficients (ICCs) and Bland–Altman plots between the two observers, and between an average of the two observers and the RIETE site-reported data were obtained.

Results Core laboratory interobserver variations were very limited with correlation coefficients >0.8 for all TTE parameters. Agreement was substantial between core laboratory observers and site-reported data for key parameters including tricuspid annular plane systolic excursion (ICC 0.728; 95% confidence interval [CI], 0.594–0.862) and pulmonary arterial systolic pressure (ICC 0.726; 95% CI, 0.601–0.852). Agreement on right-to-left ventricular diameter ratio (ICC 0.739; 95% CI, 0.443–1.000) was validated, although missing data limited the precision of the estimates. Bland–Altman plots showed differences close to zero.

Conclusion We showed substantial reliability of key RV site-reported measurements in the RIETE registry. Ascertaining the validity of such data adds confidence and reliability for subsequent investigations.

Keywords

echocardiography - right ventricular function - validity - pulmonary circulation - reliability

Data Availability

Data are available upon reasonable request.


* A full list of RIETE investigators is given in the [ Supplementary Materials ] .


Supplementary Material



Publication History

Received: 14 August 2023

Accepted: 01 November 2023

Article published online:
08 January 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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