segunda-feira, junho 04, 2012

Ventrículo direito medido e analisado


Accuracy and Interobserver Concordance of Echocardiographic Assessment of Right Ventricular Size and Systolic Function: A Quality Control Exercise

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Results

Quantitative measurements increased accuracy and interreader agreement compared to qualitative assessment alone, especially in normal categories. Readers’ accuracy for diagnosing normal and severe RVS increased from 38% to 78% (P = .001) and from 70% to 97% (P = .018), and readers’ accuracy for diagnosing normal and mild RVSF increased from 52% to 84% (P < .001) and from 36% to 56% (P = .001). Interreader agreement for classification of the subjects as normal or abnormal improved from a κ value of 0.40 to 0.77 (fair to good agreement) for RVS and from 0.43 to 0.66 (moderate to good agreement) for RVSF.

Conclusions

Visual estimation of RVS(Tamanho do VD) and RVSF (Função do VD) is inaccurate and has wide interobserver variability. Quantitation improves accuracy and reliability, especially in distinction of normal and abnormal. The reliability of mild and moderate grades remains inadequate, and further guidance is needed for the classification of abnormal categories.
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Quantas vezes avaliamos o VD apenas por critérios subjetivos e mais nada?
Essa prática está em decadência nos bons serviços.
Fazer um corte perfeito ao 4 C e medir o VD é obrigatório. E a análise da onda Sm tricúspide é fundamental.
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