August 29, 2026Journal of the American College of Cardiology300 citationsOpen Access
Reliability of echocardiographic assessment of left ventricular structure and function
Key Points
- To assess the intrapatient reliability and reproducibility of echocardiographic measurements of left ventricular mass, dimensions, and function.
- Assessed test-retest reliability between screening and baseline echocardiograms (45 ± 25 days apart) in N=183 hypertensive patients (68% men, mean age 65 ± 9 years) with left ventricular hypertrophy in the PRESERVE trial.
Structured PICO
Does echocardiographic assessment provide reliable intrapatient measurements of left ventricular mass in hypertensive patients with LV hypertrophy?
P
Population
183 hypertensive patients with left ventricular hypertrophy, mean age 65 +/- 9 years, 68% men, enrolled in the PRESERVE trial.
I
Intervention
Second echocardiogram performed 45 +/- 25 days after the initial screening echocardiogram.
C
Comparator
Initial screening echocardiogram.
O
Outcome
Intrapatient reliability of left ventricular mass measurements estimated by intraclass correlation coefficient (RHO).surrogate
Echocardiographic assessment of left ventricular mass demonstrates high intrapatient reliability with minimal regression to the mean, supporting its use for tracking true changes in LV mass.
Abstract
OBJECTIVES: The study was done to evaluate reliability of echocardiographic left ventricular (LV) mass. BACKGROUND: Echocardiographic estimation of LV mass is affected by several sources of variability. METHODS: We assessed intrapatient reliability of LV mass measurements in 183 hypertensive patients (68% men, 65 +/- 9 years) enrolled in the Prospective Randomized Enalapril Study Evaluating Regression of Ventricular Enlargement (PRESERVE) trial after a screening echocardiogram (ECHO) showed LV hypertrophy. A second ECHO was repeated at randomization (45 +/- 25 days later). Two-dimensional (2D)-guided M-mode or 2D linear measurements of LV cavity and wall dimensions were verified by one experienced reader. RESULTS: Mean LV mass was similar at first and second ECHO (243 +/- 53 vs. 241 +/- 54 g) and showed high reliability as estimated by intraclass correlation coefficient (RHO) = 0.93. Within-patient 5th, 10th, 90th and 95th percentiles of between-study difference in LV mass were -32 g, -28 g, +25 g and +35 g. Mean LV mass fell less from the first to the second ECHO than expected from a formula to predict regression to the mean (2 +/- 19 vs. 17 +/- 12 g, p or = 95% or > or = 80% likelihood of being true change.