Key result
Tissue Doppler velocities measured by the Sonos 2000 system were systematically higher than those from the Philips iE33 system (Ea mean difference 4.95 cm/s; limits of agreement 0.64-9.25 cm/s).
Why the study?
Do tissue Doppler velocities differ when measured by Sonos 2000 compared to Philips iE33 echocardiography systems?
Cross-Sectional (n=31)
Do tissue Doppler velocities differ when measured by Sonos 2000 compared to Philips iE33 echocardiography systems?
Mean Difference: 4.95 (95% CI 0.64–9.25)
Absolute Event Rate: 13.2% vs 8.3%
p-value: p=<0.0001
Tissue Doppler velocities measured by different echocardiography systems show systematic differences and broad limits of agreement, indicating that the same equipment should be used for patient follow-up.
Vendor differences in tissue Doppler velocities warrant caution for serial monitoring; leaves open prospective validation of clinical impact.
BACKGROUND: Both systolic and diastolic tissue Doppler (TD) velocities have an important diagnostic and prognostic role in cardiology. We aimed to compare TD velocities between two different echocardiography systems. PATIENTS: Thirty-one consecutive patients (mean age: 65.2 +/- 17.5 years; 12 males) were enrolled. METHODS: Systolic (Sa), early (Ea), and late (Aa) diastolic velocities were measured by TD at the lateral mitral annulus by a Sonos 2000 (Hewlett-Packard, Andover, MA, USA) and a Philips iE33 system. The E/Ea ratio was calculated. RESULTS: Ea, Aa, and Sa velocities were higher when measured by the Sonos system (Ea: 13.2 +/- 4.1 cm/s vs. 8.3 +/- 3.6 cm/s; Aa: 14.8 +/- 3.8 cm/s vs. 9.3 +/- 2.3 cm/s; Sa: 15.2 +/- 3.6 cm/s vs. 8.4 +/- 2.0 cm/s; P < 0.0001 all). A significant correlation was found in Ea and in Ea/Aa (r = 0.84 and r = 0.85 resp; P < 0.0001 for both), and a weaker in Aa (r = 0.43; P = 0.02) between the machines. The Bland-Altman analysis showed broad limits of agreement between the measurements for Ea, Aa, and Sa (mean difference: 4.95 cm/s; 5.52 cm/s; 6.73 cm/s, respectively; limits: 0.64-9.25 cm/s; -1.39-12.39 cm/s; -0.37-13.83 cm/s, respectively). An E/Ea ratio >5.6 by the Sonos system showed 75% sensitivity and 79% specificity for elevated left ventricular filling pressure, defined as E/Ea >10 by the reference Philips system. CONCLUSIONS: Although diastolic TD velocities had excellent correlations between the two machines, there was a systematic overestimation by the Sonos system. Since the limits of agreement do not allow replacing the measurements, we suggest using the same echocardiographic equipment at patient follow-up.
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Dénes et al. (2010) reported a cross-sectional. Sonos 2000 echocardiography system vs. Philips iE33 echocardiography system was evaluated on Early diastolic (Ea) velocity (MD 4.95, 95% CI 0.64-9.25, p=<0.0001). Tissue Doppler velocities measured by the Sonos 2000 system were systematically higher than those from the Philips iE33 system (Ea mean difference 4.95 cm/s; limits of agreement 0.64-9.25 cm/s).
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