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@article{Sacchi:2018:ehjci/jex218,
author = {Sacchi, S and Dhutia, N and Shun-Shin, MJ and Zolgharni, M and Sutaria, N and Francis, DP and Cole, GD},
doi = {ehjci/jex218},
journal = {EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging},
pages = {1380--1389},
title = {Doppler assessment of aortic stenosis: a 25-operator study demonstrating why reading the peak velocity is superior to velocity time integral},
url = {http://dx.doi.org/10.1093/ehjci/jex218},
volume = {19},
year = {2018}
}

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TY  - JOUR
AB  - Aims Measurements with superior reproducibility are useful clinically and research purposes. Previous reproducibilitystudies of Doppler assessment of aortic stenosis (AS) have compared only a pair of observers and have notexplored the mechanism by which disagreement between operators occurs. Using custom-designed software whichstored operators’ traces, we investigated the reproducibility of peak and velocity time integral (VTI) measurementsacross a much larger group of operators and explored the mechanisms by which disagreement arose. ...................................................................................................................................................................................................Methodsand resultsTwenty-five observers reviewed continuous wave (CW) aortic valve (AV) and pulsed wave (PW) left ventricularoutflow tract (LVOT) Doppler traces from 20 sequential cases of AS in random order. Each operator unknowinglymeasured each peak velocity and VTI twice. VTI tracings were stored for comparison. Measuring the peak is muchmore reproducible than VTI for both PW (coefficient of variation 10.1 vs. 18.0%; P < 0.001) and CW traces (coeffi-cient of variation 4.0 vs. 10.2%; P < 0.001). VTI is inferior because the steep early and late parts of the envelope aredifficult to trace reproducibly. Dimensionless index improves reproducibility because operators tended to consistentlyover-read or under-read on LVOT and AV traces from the same patient (coefficient of variation 9.3 vs.17.1%; P < 0.001). ...................................................................................................................................................................................................Conclusion It is far more reproducible to measure the peak of a Doppler trace than the VTI, a strategy that reduces measurementvariance by approximately six-fold. Peak measurements are superior to VTI because tracing the steep slopesin th
AU  - Sacchi,S
AU  - Dhutia,N
AU  - Shun-Shin,MJ
AU  - Zolgharni,M
AU  - Sutaria,N
AU  - Francis,DP
AU  - Cole,GD
DO  - ehjci/jex218
EP  - 1389
PY  - 2018///
SN  - 2047-2412
SP  - 1380
TI  - Doppler assessment of aortic stenosis: a 25-operator study demonstrating why reading the peak velocity is superior to velocity time integral
T2  - EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging
UR  - http://dx.doi.org/10.1093/ehjci/jex218
UR  - http://hdl.handle.net/10044/1/50485
VL  - 19
ER  -

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