Clinical investigationUltrasound in CV diseaseIntraobserver and Interobserver Variability of Transesophageal Echocardiography in Aortic Arch Atheroma Measurement
Section snippets
Patients and Measurements
TEE is routinely performed in all patients presenting to our institution with stroke that remains unexplained after clinical assessment, electrocardiography, and cerebrovascular imaging. Some of these patients are participating in the ARCH Trial. For the purposes of this study, 160 TEE images of the aortic arch from 96 patients were randomly selected from this cohort during a 12-month period to be subsequently remeasured by 3 different observers.
TEE Examination
Patients gave informed consent for the procedure.
Results
A total of 160 images were acquired from 96 patients (mean age 74 ± 9 years; 68% male). The mean plaque thickness derived from all measurements of all 160 images was 5.1 ± 2.3 mm, range 1.2 to 19.3 mm.
The comparisons among observers are summarized in Table.
Discussion
Although severe atheroma is a major risk factor for first and recurrent stroke, the optimal treatment strategy remains unclear. The ARCH Trial results will, therefore, be important in contributing to evidence-based management of this condition. However, for the findings to be widely applicable, TEE must be shown to be an appropriate and reliable screening tool for such patients, whether they are investigated in a dedicated stroke department at a tertiary institution or by a local cardiologist
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2013, Ultrasound in Medicine and BiologyCitation Excerpt :Zaidat et al. (2005) reported that TEE provides measurements of aortic plaque thickness and recognition of the morphologic characteristics of plaques with good reproducibility among inter- and intra-observers in stroke patients. Moreover, a recent study by Weber et al. (2008) assessed intra- and inter-observer variability for measurements of aortic plaque thickness by TEE in 160 images obtained from 96 patients. The authors concluded that this method is reproducible and is a widely applicable and reliable tool for clinical and research purposes.
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