Reliability of multicenter pediatric echocardiographic measurements of left ventricular structure and function - The prospective (PCHIV)-C-2-H-2 study

Background - To assess the reliability of pediatric echocardiographic measu rements, we compared local measurements with those made at a central facili ty. Methods and Results - The comparison was based on the first echocardiograph ic recording obtained on 735 children of HIV-infected mothers at 10 clinica l sites focusing on measurements of left ventricular (LV) dimension, wall t hicknesses, and fractional shortening. The recordings were measured locally and then remeasured at a central facility. The highest agreement expressed as an intraclass correlation coefficient (ICC=0.97) was noted for LV dimen sion, with much lower agreement for posterior wall thickness (ICC=0.65), fr actional shortening (ICC=0.64), and septal wall thickness (ICC=0.50). The m ean dimension was 0.03 cm smaller in central measurements (95% prediction i nterval [PI], -0.32 to 0.25 cm) for which 95% PI reflects the magnitude of differences between local and central measurements. Mean posterior wall thi ckness was 0.02 cm larger in central measurements (95% PI, -0.18 to 0.22 cm ). Mean fractional shortening was 1% smaller in central measurements. Howev er, the 95% PI was -10% to 8%, indicating that a fractional shortening of 3 2% measured centrally could be anywhere between 22% and 40% when measured l ocally. Central measurements of mean septal thickness were approximate to0. 1 cm thicker than local ones (95% PI, -0.18 to 0.34 cm). Centrally measured wall thickness was more closely related to mortality and possibly was more valid than local measurements. Conclusions - Although LV dimension was reliably measured, local measuremen ts of LV wall thickness and fractional shortening differed from central mea surements.