Agreement on LVEF and wall motion abnormalities assessed by TTE
and HHU:
To measure the agreement level, the concordance correlation coefficient
(r) was calculated for both TTE and HHU (Fig 1A). The r-value for LVEF
between the standard TTE and HHE was 0.71 (95% confidence interval
[CI]: 0.58 to 0.81, p value < 0.0001). Figure 1C shows the
Bland-Altman plot for agreement between HHE and TEE for assessing LVEF:
the majority of measurements fell within the 95% confidence interval
indicating the high agreement between the two methods.
The concordance correlation coefficient for WMSI between the standard
TTE and HHE was 0.76 (95% CI: 0.65 to 0.84, p value < 0.0001)
(Fig 1B). Similarly, a Bland-Altman graph generated from the WMSI data
showed that majority of measurements for wall motion abnormalities were
seen within the range of the 95% confidence interval (Fig 1D). The
largest difference in WMSI between the HHU and standard TTE occurred in
the mid to upper to end of the reported range, between 1.5 and 2.5.
We also calculated the agreement for the presence of segmental regional
wall-motion abnormalities between the HHU and standard TTE for each of
the 16 segments of left ventricle. Agreement was variable among
different LV segments with r-values ranging between 0.48 to 0.80. It was
highest for the mid inferoseptal wall (0.80) on apical view and mid
inferolateral wall (0.77) on parasternal long axis, and lowest for the
basal anterior (0.5) and basal inferior (0.51) walls on parasternal
short axis views (Table 2).