Author + information
- Jeremy Thaden,
- Michael Tsang,
- Chadi Ayoub,
- Ratnasari Padang,
- Vuyisile Nkomo,
- Stephen Tucker,
- Cynthia Cassidy,
- Merri Bremer,
- Garvan Kane and
- Patricia Pellikka
Background: It is presumed that laboratory accreditation is associated with improved quality, but there are few data. We sought to compare the quality of echocardiographic examinations performed at accredited vs non-accredited laboratories for the evaluation of valvular heart disease (VHD).
Methods: We enrolled consecutive subjects with VHD who underwent echocardiography at our institution and at an outside institution within 6 months. Completeness and quality of reports and images were assessed by blinded investigators. Studies were graded in accordance with current Intersocietal Accreditation Commission and American Society of Echocardiography Standards. We compared studies performed at accredited vs non-accredited and external vs our own internal accredited laboratory.
Results: Among 335 studies, 253 (76%) were from accredited laboratories. Accredited sites more frequently reported patient sex (94% vs 78%, p=0.0002), height and weight (96% vs 63%, p<0.0001), blood pressure (86% vs 39%, p<0.0001), an assessment of left ventricular size (96% vs 83%, p=0.0002) and right ventricular size and function (94% vs 80% and 87% vs 73%, respectively; p<0.006 for both). Accredited laboratories had higher rates of complete and diagnostic color Doppler and spectral Doppler imaging (58% vs 35% and 45% vs 21%, respectively; p<0.05 for each). Concordant grading of severity between external and internal interpretation of outside images improved when diagnostic quantitation was performed (85% vs 69%, p=0.003) and, in patients with mitral regurgitation, better color Doppler image quality was also associated with improved concordance (84% vs 60%, p=0.006 for complete/diagnostic vs suboptimal image quality, respectively).
Conclusions: Accredited echocardiographic laboratories had more complete reporting and better image quality. Echocardiographic quantitation and color Doppler image quality were associated with improved concordance in grading severity of VHD. Accreditation standards should stress the importance of high quality color Doppler imaging along with echocardiographic quantitation to improve the accuracy, reproducibility, and quality of echocardiographic studies for VHD.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Innovative Use of Echocardiography
Abstract Category: 28. Non Invasive Imaging: Echo
Presentation Number: 1197-215
- 2017 American College of Cardiology Foundation