What is the clinical evidence from this study?

Study design: Observational. Population: Normal cardiac evaluation (n=21). Intervention: Noninvasive diastolic stress testing (NDST). Primary outcome: Interobserver agreement (Cohen κ 0.44).

What does this research mean for the field?

Noninvasive diastolic stress testing is feasible and reliable in 10- to 21-year-olds, demonstrating 81% interobserver agreement between blinded readers. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 2025Journal of Clinical Exercise Physiology

Feasibility of Noninvasive Diastolic Stress Testing in the 10- to 21-Year-Old Age Group

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Key result

Noninvasive diastolic stress testing shows feasibility and reliability in youth with ~81% interobserver agreement.

Cohen κ 0.44
n=21

Why the study?

Noninvasive diastolic stress testing is used in adults to reveal left ventricular diastolic dysfunction during exercise, but data in young individuals are limited.

Is noninvasive diastolic stress testing feasible and reliable in individuals aged 10 to 21 years with normal cardiac evaluations?

Population

21 participants aged 10-21 years with a normal cardiac evaluation

Design

Feasibility study with blinded echocardiographic reading

Authors

MRMichael A. RebolledoUniversity of Tennessee Health Science Center WSWebb A. SmithUniversity of Tennessee Health Science Center JMJayme A. McGrailLe Bonheur Children's Hospital

Discussion

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Implication

Supports feasibility in healthy youth; leaves open validation in clinical populations with suspected dysfunction.

Key Points

To assess the feasibility and interobserver reliability of noninvasive diastolic stress testing (NDST) using exercise echocardiography in individuals aged 10 to 21 years.
Enrolled 21 participants (mean age 15.3 ± 3 years; 1 excluded for obesity) with normal cardiac evaluations from an outpatient cardiology center.
Conducted baseline and graduated exercise echocardiography at 10, 20, and 30 W using a semirecumbent cycle ergometer, measuring left ventricular diastolic parameters during exercise and at 5- and 10-minute recovery.
Determined interobserver variability through independent reviews of echocardiograms by two blinded pediatric cardiologists.
Interobserver agreement between the two blinded cardiologists reached 81%, with a Cohen κ coefficient of 0.44 indicating moderate agreement.
Mitral E/e′ ratios remained within normal limits across all graded exercise workloads and recovery intervals.

Study Design

Type

Observational (n=21)

Blinding

Blinded readers

Multicenter

Structured PICO

Is noninvasive diastolic stress testing feasible and reliable in individuals aged 10 to 21 years with normal cardiac evaluations?

Population

21 individuals aged 10 to 21 years with a normal cardiac evaluation, mean age 15.3 ± 3 years, BMI 21.2 ± 3.1 kg/m2.

Intervention

Noninvasive diastolic stress testing (NDST) using a semirecumbent cycle ergometer at 10, 20, and 30 W with echocardiography at rest, during exercise, and at 5- and 10-minute recovery.

Outcome

Feasibility and reliability (interobserver variability) of NDSTsurrogate

Main Result

Effect estimate: Cohen κ 0.44

Noninvasive diastolic stress testing is a feasible and moderately reliable technique for evaluating left ventricular diastolic parameters during exercise in healthy youth aged 10 to 21 years.

Cite This Study

Rebolledo et al. (2025) conducted an observational in Normal cardiac evaluation (n=21). Noninvasive diastolic stress testing (NDST) was evaluated on Interobserver agreement (Cohen κ 0.44). Noninvasive diastolic stress testing is feasible and reliable in 10- to 21-year-olds, demonstrating 81% interobserver agreement (Cohen κ 0.44) between blinded readers.

synapsesocial.com/papers/6a15ca96a4734e8e604e7104 https://doi.org/10.31189/2165-6193-14.1.17

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Feasibility of Noninvasive Diastolic Stress Testing in the 10- to 21-Year-Old Age Group

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Feasibility of Noninvasive Diastolic Stress Testing in the 10- to 21-Year-Old Age Group

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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