Agreement Between Centers on the Interpretation of Exercise Echocardiography

Peak treadmill exercise echocardiography: not feasible?

“…Besides, the agreement between centres on the interpretation of exercise echocardiography has been also explored in a multicentric study, in which peak imaging in treadmill was obtained for most of the patients (125/150 patients included). The agreement was moderate 6 (k ¼ 0.48; intercentre range 0.45 -0.52), which is similar to the inter-institutional agreement for dobutamine stress echo. Other advantages of peak over post-exercise treadmill echocardiography include capability of acquiring images in case of doubts about clinical symptoms or ECG changes at any step of the exercise protocol, a relative lack of hurry in comparison with the post-exercise approach in which images should be ideally acquired in ,60 s, and the possibility of using the narrow post-exercise time period to obtain 'complementary' data such as mitral regurgitation or diastolic function assessment.…”

Peak treadmill exercise echocardiography for ischemia detection

“…35 Third, imaging interpretation is based on a semi-quantitative approach, with just moderate interobserver agreement. 36,37 However, the agreement is higher in cases of severe ischemia, and in cases of multivessel CAD as defined by angiography. 36 Reading of WMA may also be tricky in presence of left bundle branch block (LBBB), paced rhythm (PR), and atrial fibrillation (AF).…”

“…Third, imaging interpretation is based on a semi‐quantitative approach, with just moderate interobserver agreement 36,37 . However, the agreement is higher in cases of severe ischemia, and in cases of multivessel CAD as defined by angiography 36 .…”

Exercise echocardiography

“…Thirdly, imaging interpretation is made by a semi-quantitative approach, which has led to only moderate agreement between observers in different studies [16,17] . However, this agreement is higher when either significant WMA or extensive CAD, as defined by angiography, is present.…”