Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Cardiology, Copenhagen University Hospital Herlev, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
J Am Soc Echocardiogr. 2019 Jul;32(7):895-905.e2. doi: 10.1016/j.echo.2019.02.015. Epub 2019 May 7.
The Copenhagen Baby Heart Study (CBHS) is a population-based cohort study of neonates (N = 25,000), including echocardiography. Echocardiography in neonates is mainly focused on congenital heart disease (CHD), whereas general aspects of cardiac dimensions and function in neonates without CHD remain to be further addressed.
This study was conducted to assess the reliability of neonatal echocardiography and validity of echocardiographic methods used in the CBHS.
Reliability and agreement were tested for two-dimensional (2D), M-mode, spectral Doppler, and tissue velocity echocardiography for the following. (1) Measurements: seven sonographers independently performed two measurement rounds: (a) measurement of the same 50 echocardiograms (n = 350 echocardiograms measured) and (b) repeated measurement of 25 of the 50 echocardiograms (n = 175 echocardiograms measured). (2) Acquisition: four sonographers independently performed two rounds of echocardiographic acquisition and subsequent measurement of the same 22 neonates (n = 176 acquisitions and measures). Intra- and interobserver variabilities were assessed by determinations of coefficient of variation (CV), intraclass correlation coefficient (ICC), Bland-Altman plot, and 95% limits of agreement.
(1) Measurements: we found intra- and interobserver ICC ≥ 0.67 for 2D parameters, except for left ventricular (LV) wall thicknesses and LV diameter (interobserver); ICC ≥ 0.84 for tricuspid annular plane systolic excursion (TAPSE); ICC ≥ 0.93 for pulsed-wave Doppler (PW); ICC ≥ 0.84 for continuous-wave Doppler; and ICC ≥ 0.87 for tissue velocity parameters. We found CV < 15% for all parameters except LV wall thicknesses. (2) Acquisition: we found intra- and interobserver ICC ≥ 0.69 for 2D parameters, except for LV wall thicknesses, aortic valve annulus (interobserver), and LV end-systolic diameter (interobserver); ICC = 0.45-0.49 for TAPSE; ICC = 0.48-0.64 for PW; and ICC ≥ 0.70 for continuous wave. We found CV < 15% for all parameters.
Reliability of echocardiographic measurements and acquisition of cardiac dimensions and function were good for most parameters but lower for TAPSE (acquisition) and PW Doppler (acquisition) and poor for LV wall thicknesses. In general, echocardiography of cardiac dimensions and function in the neonate is reliable.
哥本哈根婴儿心脏研究（CBHS）是一项基于人群的新生儿队列研究，包括超声心动图检查。新生儿的超声心动图主要集中在先天性心脏病（CHD）上，而没有 CHD 的新生儿心脏的一般维度和功能仍需要进一步研究。
本研究旨在评估新生儿超声心动图的可靠性和 CBHS 中使用的超声心动图方法的有效性。
对于二维（2D）、M 模式、频谱多普勒和组织速度超声心动图，对以下方面进行了可靠性和一致性测试。（1）测量：7 名超声医师独立进行两轮测量：（a）对 50 份超声心动图（n=350 份测量）进行重复测量，（b）对 50 份超声心动图中的 25 份进行重复测量（n=175 份测量）。（2）采集：4 名超声医师独立进行两轮采集和随后对 22 名新生儿进行的相同测量（n=176 次采集和测量）。通过变异系数（CV）、组内相关系数（ICC）、Bland-Altman 图和 95%一致性界限来评估观察者内和观察者间的可变性。
（1）测量：我们发现 2D 参数的观察者内和观察者间 ICC≥0.67，除了左心室（LV）壁厚度和 LV 直径（观察者间）；三尖瓣环平面收缩期位移（TAPSE）的 ICC≥0.84；脉冲波多普勒（PW）的 ICC≥0.93；连续波多普勒的 ICC≥0.84；组织速度参数的 ICC≥0.87。除了 LV 壁厚度外，我们发现所有参数的 CV<15%。（2）采集：我们发现 2D 参数的观察者内和观察者间 ICC≥0.69，除了 LV 壁厚度、主动脉瓣环（观察者间）和 LV 收缩末期直径（观察者间）；TAPSE 的 ICC=0.45-0.49；PW 的 ICC=0.48-0.64；连续波的 ICC≥0.70。我们发现所有参数的 CV<15%。
大多数参数的超声心动图测量和心脏维度及功能的采集可靠性良好，但 TAPSE（采集）和 PW 多普勒（采集）的可靠性较低，LV 壁厚度的可靠性较差。总的来说，新生儿心脏维度和功能的超声心动图是可靠的。
