Reproducibility of Echocardiographic Traits in the “Urinary Proteomics Combined With Home Blood Pressure Telemonitoring for Health Care Reform Study” Participants From Poland.

Objective: To evaluate intra- and inter-observer reproducibility of echocardiographic parameters assessed in a single centre within the UPRIGHT-HTM study, with relevance for hypertension-mediated cardiac damage and heart failure phenotyping.Design and method: Thirty-six participants (19 women, 17 men; aged 55–75 years) underwent baseline transthoracic echocardiography. Diastolic function was assessed using E and A waves and the E wave to e prime ratio (E/e’). Systolic function included left ventricular ejection fraction (LVEF, Teichholz method), stroke volume, and cardiac output. Three experienced observers analysed identical image loops acquired using the same ultrasound system (Vivid S70), with measurements averaged over three cardiac cycles. Intra-observer reproducibility was assessed by repeated analysis of recordings from 12 participants per observer, while inter-observer reproducibility was evaluated by independent analysis of six recordings from the other observers (Figure 1). Agreement was quantified using intraclass correlation coefficients (ICC), coefficients of variation (CV), repeatability coefficients, Cohen's kappa, and Bland–Altman analysis. Results: Intra-observer reproducibility was consistently higher than inter-observer reproducibility across all parameters. Intra-observer ICCs ranged from 0.65 to 0.98, indicating good to excellent repeatability. Inter-observer ICCs showed wider variability (0.28–0.93). Diastolic indices demonstrated the highest reproducibility, with good to excellent inter-observer agreement for E/A and E/e’ ratios (ICC 0.72–0.93). Structural parameters showed acceptable reproducibility, particularly in intra-observer analyses. In contrast, stroke volume and cardiac output demonstrated good intra-observer repeatability but only moderate inter-observer reproducibility (ICC 0.42–0.45). LVEF assessed using the Teichholz method showed moderate agreement. Bland–Altman analysis revealed no clinically relevant systematic bias. Conclusions: Echocardiographic parameters in the UPRIGHT-HTM study demonstrated satisfactory reproducibility, particularly for diastolic function and cardiac geometry, which are crucial for assessing hypertension-mediated organ damage and heart failure with preserved ejection fraction (HFpEF) phenotyping. High inter-observer agreement and measurement stability substantially reduce the risk of clinical misclassification and enhance the reliability of echocardiography for longitudinal patient assessment. The demonstrated robustness of measurements supports their use in routine clinical decision-making.