Previous studies
The inter-observer variability during EDE right heart and pulmonary circulation studies may be not negligible. Few such studies have been previously reported and all were mono-centric.3,17Argiento et al reported in 124 healthy subjects (62 women and 62 men; age 37 ± 13 yrs) (single center study) an inter-observer variability for pulmonary artery systolic pressure (PASP) and cardiac output (CO) estimates of 1.9 % and 4.9 % at rest, and 7.9 % and 13.9 % at maximum exercise, respectively.18 D’Alto et al reported in 90 healthy subjects (45 male, mean age 39 ±13 years) inter-observer variabilities between two readers at rest and peak exercise of 1.9% and 7.9% for PASP, 4.9% and 13.9% for stroke volume, 2.6% and 6.8% for TAPSE, and 5.4% and 8.7% for S’, respectively.19 Kusunose et al reported in a subgroup of 15 randomly selected subjects with isolated moderate to severe mitral regurgitation a close inter- and intra-observer variability for resting TAPSE (8.8%) and exercise TAPSE (9.5%).20 As these data remain limited, more validation appeared necessary for a multi-centric study like the RIGHT-NET.