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Reliability of Tricuspid Regurgitant Jet Velocity Measurements in Children and Young Adults with Sickle Cell Disease
Abstract 2581 Poster Board II-558 Tricuspid regurgitant jet velocity (TRJV) measurements are used commonly for estimating pulmonary artery pressures among individuals with sickle cell disease (SCD) undergoing screening for pulmonary hypertension, defined by TRJV ≥ 2.5 m/sec. Measurements, however, m...
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Published in: | Blood 2009-11, Vol.114 (22), p.2581-2581 |
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Main Authors: | , , , , , |
Format: | Article |
Language: | English |
Online Access: | Get full text |
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Summary: | Abstract 2581
Poster Board II-558
Tricuspid regurgitant jet velocity (TRJV) measurements are used commonly for estimating pulmonary artery pressures among individuals with sickle cell disease (SCD) undergoing screening for pulmonary hypertension, defined by TRJV ≥ 2.5 m/sec. Measurements, however, may be prone to variability and have not been subjected to reliability testing in this population. The objective of our study was to examine reliability as well as potential sources of variability associated with TRJV measurements in a cohort of children and young adults with SCD.
We evaluated TRJV at steady state in a convenience sample of 30 subjects (53% male) with SCD (SS n=25, SC n=1, S-Beta0 thalassemia n=4) during 2 separate visits 1 week apart. In a blinded fashion, peak TRJV was independently measured by 2 experienced sonographers and officially interpreted by 2 readers who were attending cardiologists at standard time points in the protocol that permitted assessment of reliability and agreement. We calculated within subject variability as well as intra-/inter-sonographer and reader reliability in this analysis using Intraclass Correlation Coefficient (ICC) and Cohen's kappa to assess TRJV as a continuous and categorical variable, respectively. Agreement was also examined graphically using Bland-Altman plots.
Sonographers were able to measure TRJV in all subjects (mean age, 15.8±3.3 years, range 10 to 22). Readers, however, designated tricuspid regurgitation unquantifiable in 13% of their final interpretations, most commonly due to an inadequate Doppler window. We found that intra-reader reliability was highest (ICC=0.93 [95% CI 0.86, 0.97], p |
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ISSN: | 0006-4971 1528-0020 |
DOI: | 10.1182/blood.V114.22.2581.2581 |