Test-retest variability of volumetric right ventricular measurements using real-time three-dimensional echocardiography

H.B. van der Zwaan, M.L. Geleijnse, Ol Soliman, J.S. McGhie, E.J. Wiegers-Groeneweg, W.A. Helbing, J.W. Roos-Hesselink, F.J. Meijboom

Research output: Contribution to journalArticleAcademicpeer-review


BACKGROUND: Substantial variability in sequential echocardiographic right ventricular (RV) quantification may exist. Interobserver and intraobserver values are well known, but acquisition (test-retest) variability has been rarely assessed. The objective of this study was to determine the test-retest variability of sequential RV volume and ejection fraction (EF) measurements by real-time three-dimensional echocardiography in patients with congenital heart disease and healthy controls.

METHODS: Twenty-eight participants (21 patients with congenital heart disease, seven healthy controls; mean age, 30 ± 14 years; 43% men) underwent a series of three echocardiographic studies. To obtain interobserver and intraobserver test-retest variability, two sonographers acquired sequential RV data sets in each participant during one outpatient visit. RV volumetric quantification was done using semiautomated three-dimensional border detection. The variability data were analyzed using correlation coefficients, Bland-Altman analysis, and coefficients of variation.

RESULTS: Absolute mean differences for sequential intraobserver acquisitions were 12 ± 12 mL for end-diastolic volume, 7 ± 6 mL for end-systolic volume, and 4 ± 3% for EF. Interobserver and intraobserver test-retest variability, respectively, were 7% and 7% for RV end-diastolic volume, 14% and 7% for end-systolic volume, and 8% and 6% for EF.

CONCLUSIONS: Good test-retest variability, besides the practical nature of real-time three-dimensional echocardiography for RV volume and EF assessment, makes it a valuable technique for serial follow-up. Although it may be challenging to diminish all factors that can influence echocardiographic examination for serial follow-up, standardization of RV size and functional measurements should be a goal to produce more interchangeable data.

Original languageEnglish
Pages (from-to)671-679
Number of pages9
JournalJournal of the American Society of Echocardiography
Issue number6
Publication statusPublished - Jun 2011


  • Adult
  • Case-Control Studies
  • Echocardiography, Three-Dimensional
  • Female
  • Heart Defects, Congenital
  • Humans
  • Male
  • Prospective Studies
  • Reproducibility of Results
  • Stroke Volume
  • Ventricular Dysfunction, Right


Dive into the research topics of 'Test-retest variability of volumetric right ventricular measurements using real-time three-dimensional echocardiography'. Together they form a unique fingerprint.

Cite this