Inter‐ and intra‐observer variability in the echocardiographic evaluation of wall motion abnormality in patients with ST‐elevation myocardial infarction or takotsubo syndrome – A novel approach

Abstract

Introduction and Objectives Using existing transthoracic echocardiographic indices to quantify left ventricular wall motion abnormalities (WMAs) can be difficult due to the variations in the location of the abnormalities within the left ventricle, the quality of examinations, and the inter‐/intra‐observer variability of available indices. This study aimed to evaluate a new approach for measuring the extent of WMA by calculating the percentage of abnormal wall motion and comparing it to the wall motion score index (WMSI). The study also sought to assess inter‐ and intra‐observer variability. Methods The study included 140 echocardiograms from 54 patients presenting with ST‐elevation myocardial infarction or Takotsubo syndrome. All patients underwent an echocardiographic examination according to a standard protocol and the images were used to measure the extent of akinesia (proportion akinesia, PrA), akinesia and hypokinesia (proportion akinesia/hypokinesia, PrAH), and WMSI. The inter‐observer variability between the two operators was analyzed. The intra‐observer analysis was performed by one observer using the same images at least 1 month after the first measurement. The agreement was analyzed using the Pearson correlation coefficient and Bland‐Altman plots. Results Inter‐ and intra‐observer variability for PrA and PrAH were low and comparable to those for WMSI. Conclusion PrA and PrAH are reliable and reproducible echocardiographic methods for the evaluation of left ventricular wall motion.

Development of a small animal model replicating core characteristics of takotsubo syndrome in humans

“…To systematically assess this variability, we quantified the extent of akinesia, an established metric in both pre-clinical and clinical studies of TS. 6 , 23 The response to catecholamines is pivotal and warrants deeper exploration to elucidate why certain individuals exhibit apical ballooning, while others do not under analogous conditions. Further, it is imperative to differentiate the transient loss of cardiac function in specific regions following stress, a phenomenon well-documented in TS patients.…”