Interobserver variability in estimation of the left ventricular systolic function of dilated cardiopathies: Ejection fraction and global longitudinal strain

Abstract

The biplane ejection fraction (LVEF) and the left ventricular longitudinal strain (GLS) are two reliable echocardiographic parameters in the evaluation of dilated cardiopathies. The objective of this work was to study the variability of these echocardiographic parameters within the Abidjan Heart Institute (echocardiography laboratory) according to two operators. Prospective analysis that included 17 patients admitted consecutively to the institute of cardiology in a table of overall heart failure on dilated cardiopathy. The analysis focused on the values of LVEF and GLS obtained by two different operators (cardiologists, O.B. and AKJB). These parameters were all measured using a General Electric ® VIVID S6 ultrasound system. The study of variability was based on the Pearson correlation test. We included 17 patients (9 men and 8 women) of average age 49.26 ± 18.34 years. The difference between the ejection fractions obtained in SIMPSON BIPLAN mode was between 0 and 10% with an average variation of the order of 4.27%. The correlation coefficient (0.894) was significant ( P = 0.0001). The GLS values between the two operators varied between −3% and −0.30% with an average deviation of −1.35%. The correlation coefficient 0.967 was significant ( P = 0.0001). There was a significant correlation between the values of the LVEF and those of the GLS obtained by the two operators. The GLS is an important evaluation parameter because it seems less subject to interoperator variability. Whatever the operator, these two parameters are quite reliable in the diagnosis and follow-up of dilated cardiac diseases. However, it requires special equipment and training.