Reliability of Visual Assessment of Global and Segmental Left Ventricular Function: A Multicenter Study by the Israeli Echocardiography Research Group

David S. Blondheim*, Ronen Beeri, Micha S. Feinberg, Mordehay Vaturi, Sarah Shimoni, Wolfgang Fehske, Alik Sagie, David Rosenmann, Peter Lysyansky, Lisa Deutsch, Marina Leitman, Rafael Kuperstein, Ilan Hay, Dan Gilon, Zvi Friedman, Yoram Agmon, Yossi Tsadok, Noah Liel-Cohen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


Background: The purpose of this multicenter study was to determine the reliability of visual assessments of segmental wall motion (WM) abnormalities and global left ventricular function among highly experienced echocardiographers using contemporary echocardiographic technology in patients with a variety of cardiac conditions. Methods: The reliability of visual determinations of left ventricular WM and global function was calculated from assessments made by 12 experienced echocardiographers on 105 echocardiograms recorded using contemporary echocardiographic equipment. Ten studies were reread independently to determine intraobserver reliability. Results: Interobserver reliability for visual differentiation between normal, hypokinetic, and akinetic segments had an intraclass correlation coefficient of 0.70. The intraclass correlation coefficient for dichotomizing segments into normal versus other abnormal was 0.63, for hypokinetic versus other scores was 0.26, and for akinetic versus other scores was 0.58. Similar results were found for intraobserver reliability. Interobserver reliability for WM score index was 0.84 and for left ventricular ejection fraction was 0.78. Similar values were obtained for the intraobserver reliability of WM score index and ejection fraction. Compared to angiographic data, the accuracy of segmental WM assessments was 85%, and correct determination of the culprit artery was achieved in 59% of patients with myocardial infarctions. Conclusion: Among experienced readers using contemporary echocardiographic equipment, interobserver and intraobserver reliability was reasonable for the visual quantification of normal and akinetic segments but poor for hypokinetic segments. Reliability was good for the visual assessment of global left ventricular function by WM score index and ejection fraction.

Original languageAmerican English
Pages (from-to)258-264
Number of pages7
JournalJournal of the American Society of Echocardiography
Issue number3
StatePublished - Mar 2010
Externally publishedYes


  • Echocardiography
  • Ejection fraction
  • Reliability
  • Variability
  • Wall motion


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