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Methodological approach for the assessment of ultrasound reproducibility of cardiac structure and function: a proposal of the study group of Echocardiography of the Italian Society of Cardiology (Ultra Cardia SIC) Part I

Maurizio Galderisi1*, Stefano Nistri2, Sergio Mondillo3, Maria-Angela Losi4, Pasquale Innelli5, Donato Mele6, Denisa Muraru7, Antonello D'Andrea8, Piercarlo Ballo9, Aurelio Sgalambro10, Roberta Esposito1, Giuliano Marti11, Alessandro Santoro1, Eustachio Agricola12, Luigi P Badano7, Roberto Marchioli13, Pasquale Perrone Filardi13, Giuseppe Mercuro13, Paolo Nicola Marino13 and Working Group of Echocardiography, Italian Society of Cardiology

Author Affiliations

1 Department of Clinical and Experimental Medicine, Federico II University Hospital, Via S. Pansini 5, 80131, Naples, Italy

2 CMSR Veneto Medica, Via Vicenza 204, 36077, Altavilla Vicentina (Vicenza), Italy

3 Department of Cardiovascular Diseases, "Le Scotte" University Hospital, 53100 Siena, Italy

4 Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Federico II University Hospital, Via S. Pansini 5, 80131 Naples, Italy

5 Division of Cardiology, Hospital of Villa d'Agri. Via Provinciale, 85050 Villa d'Agri (Potenza), Italy

6 Department of Cardiology, University of Ferrara,, Corso Giovecca 203, 44100 Ferrara, Italy

7 Department of Cardiology, Vascular and Thoracic Sciences, University of Padua, Via Giustiniani 2, 35100 Padua, Italy

8 Department of Cardiology, Second University of Naples, "dei Colli - Monaldi" Hospital, Via L. Bianchi, 80131, Naples, Italy

9 Department of Cardiology, S. Maria Annunziata Hospital, Via dell'Antella 58, 50100 Florence, Italy

10 Department of Cardiology, Careggi University Hospital, 50141 Florence, Italy

11 Clinical Cardiology, University of Eastern Piedmont, "Maggiore della Carità" University Hospital, Corso Mazzini 18, 28100 Novara, Italy

12 Division of Cardiology, Non invasive diagnostics, Cardio-Thorax-Vascular Department San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy

13 Research Centre, Italian Society of Cardiology, Via Po' 24, 00198, Roma, Italy

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Cardiovascular Ultrasound 2011, 9:26  doi:10.1186/1476-7120-9-26

Published: 26 September 2011


When applying echo-Doppler imaging for either clinical or research purposes it is very important to select the most adequate modality/technology and choose the most reliable and reproducible measurements. Quality control is a mainstay to reduce variability among institutions and operators and must be obtained by using appropriate procedures for data acquisition, storage and interpretation of echo-Doppler data. This goal can be achieved by employing an echo core laboratory (ECL), with the responsibility for standardizing image acquisition processes (performed at the peripheral echo-labs) and analysis (by monitoring and optimizing the internal intra- and inter-reader variability of measurements). Accordingly, the Working Group of Echocardiography of the Italian Society of Cardiology decided to design standardized procedures for imaging acquisition in peripheral laboratories and reading procedures and to propose a methodological approach to assess the reproducibility of echo-Doppler parameters of cardiac structure and function by using both standard and advanced technologies. A number of cardiologists experienced in cardiac ultrasound was involved to set up an ECL available for future studies involving complex imaging or including echo-Doppler measures as primary or secondary efficacy or safety end-points. The present manuscript describes the methodology of the procedures (imaging acquisition and measurement reading) and provides the documentation of the work done so far to test the reproducibility of the different echo-Doppler modalities (standard and advanced). These procedures can be suggested for utilization also in non referall echocardiographic laboratories as an "inside" quality check, with the aim at optimizing clinical consistency of echo-Doppler data.

Doppler echocardiography; Clinical trials; Quality control; Reproducibility; Echo core laboratory