Skip Navigation



European Heart Journal Advance Access published online on April 13, 2006
European Heart Journal, doi:10.1093/eurheartj/ehi883
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
27/12/1459    most recent
ehi883v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Paetsch, I.
Right arrow Articles by Nagel, E.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Paetsch, I.
Right arrow Articles by Nagel, E.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2006; all rights reserved
Received October 17, 2005
Revised February 28, 2006
Accepted March 23, 2006

Clinical research

Determination of interobserver variability for identifying inducible left ventricular wall motion abnormalities during dobutamine stress magnetic resonance imaging

Ingo Paetsch 1 *, Cosima Jahnke 1, Victor A. Ferrari 2, Frank E. Rademakers 3, Patricia A. Pellikka 4, W. Gregory Hundley 5, Don Poldermans 6, Jeroen J. Bax 7, Karl Wegscheider 8, Eckart Fleck 1, and Eike Nagel 1

1 Department of Cardiology, German Heart Institute Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
2 Department of Medicine, Cardiovascular Medicine Division, University of Pennsylvania Medical School, Pennsylvania, PA, USA
3 Department of Cardiology, Gasthuisberg University Hospital, Leuven, Belgium
4 Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, MN, USA
5 Department of Internal Medicine/Cardiology Section, Wake Forest University School of Medicine, Winston-Salem, North Carolina, NC, USA; Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, NC, USA
6 Department of Cardiology, Thorax Center Rotterdam, The Netherlands
7 Department of Cardiology, Leiden University Medical Center, The Netherlands
8 Institute for Statistics and Econometry, University of Hamburg, Hamburg, Germany

* To whom correspondence should be addressed.
Ingo Paetsch, E-mail: paetsch{at}dhzb.de


  Abstract

Aims To determine the interobserver variability for identifying inducible left ventricular (LV) wall motion abnormalities during high-dose dobutamine/atropine stress cardiovascular magnetic resonance (DSMR).

Methods and results Four readers from various institutions were supplied with the image data from 150 consecutive DSMR examinations and asked to grade wall motion and image quality throughout graded doses of dobutamine infusion administered to achieve 85% of the maximum age-predicted heart rate. Inducible ischaemia was identified if more than one segment demonstrated a new or worsening LV wall motion abnormality, and significant stenosis was defined as ≥50% luminal diameter reduction by quantitative contrast coronary angiography. Seventy-seven patients (51%) had luminal narrowings ≥50%. Diagnostic performance (sensitivity, specificity, diagnostic accuracy) of all readers was 78.2, 87.0 and 82.5%. Disagreement between two readers occurred in every seventh examination. Agreement on the presence or absence of inducible wall motion abnormalities was moderate (mean kappa value 0.59, range 0.52-0.76). Diagnostic performance and disagreement were independent of the presence of luminal narrowings ≥50% or the number of diseased coronary vessels. Image quality was regarded excellent in 89.3% of standard views.

Conclusion In the setting of multiple observers from different institutions performing a diagnostic reading of DSMR examinations carried out at a single centre, the interobserver variability was low for identifying inducible LV wall motion abnormalities indicative of coronary arterial luminal narrowings ≥50%.

Keywords: Cardiac magnetic resonance imaging; Dobutamine stress; Wall motion analysis; Reader variability.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
T. Lockie, E. Nagel, S. Redwood, and S. Plein
Use of Cardiovascular Magnetic Resonance Imaging in Acute Coronary Syndromes
Circulation, March 31, 2009; 119(12): 1671 - 1681.
[Full Text] [PDF]

Home page
 HeartHome page
W P Bandettini and A E Arai
Advances in clinical applications of cardiovascular magnetic resonance imaging
Heart, November 1, 2008; 94(11): 1485 - 1495.
[Abstract] [Full Text] [PDF]

Home page
 Circ Cardiovasc ImagingHome page
R. Gebker, C. Jahnke, R. Manka, A. Hamdan, B. Schnackenburg, E. Fleck, and I. Paetsch
Additional Value of Myocardial Perfusion Imaging During Dobutamine Stress Magnetic Resonance for the Assessment of Coronary Artery Disease
Circ Cardiovasc Imaging, September 1, 2008; 1(2): 122 - 130.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
E. Dall'Armellina, T. M. Morgan, S. Mandapaka, W. Ntim, J. J. Carr, C. A. Hamilton, J. Hoyle, H. Clark, P. Clark, K. M. Link, et al.
Prediction of Cardiac Events in Patients With Reduced Left Ventricular Ejection Fraction With Dobutamine Cardiovascular Magnetic Resonance Assessment of Wall Motion Score Index
J. Am. Coll. Cardiol., July 22, 2008; 52(4): 279 - 286.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
K. R. Nandalur, B. A. Dwamena, A. F. Choudhri, M. R. Nandalur, and R. C. Carlos
Diagnostic Performance of Stress Cardiac Magnetic Resonance Imaging in the Detection of Coronary Artery Disease: A Meta-Analysis
J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1343 - 1353.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
R. Hoffmann
The demystification of magnetic resonance imaging?
Eur. Heart J., June 2, 2006; 27(12): 1394 - 1395.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.