{"id":5421,"date":"2026-03-13T13:11:43","date_gmt":"2026-03-13T11:11:43","guid":{"rendered":"https:\/\/cvja.co.za\/journal\/?p=5421"},"modified":"2026-06-22T08:23:30","modified_gmt":"2026-06-22T06:23:30","slug":"cvja-2025-114","status":"publish","type":"post","link":"https:\/\/cvja.co.za\/journal\/cvja-2025-114\/","title":{"rendered":"Intra- and inter-rater reproducibility of the echocardiographic data of the Nigerian UPRIGHT-HTM trial participants"},"content":{"rendered":"    <div id=\"article\">                                                                                                                        \r\n        <div id=\"title-container\">                                                                                                    \r\n        <div id=\"authors-title\">                                                                                                            \r\n        <!--Aurthors under Title-->                                                                                                            \r\n            \r\nBabangida S. Chori, Dong-Yan Zhang, Samuel E. Antia, Ojonoma Ajanya, Collins N. Ugwu, Chidiebere V. Ugwueze, Arinze F. Obasi, Olugbenga O. Abiodun, Muhammad N. Shehu, Bushra M. Sanni, Sanusi Garba, Yu-Ling Yu, De-Wei An, Katarzyna Stolarz-Skrzypek, Marek Rajzer, Dries S. Martens, Tim S. Nawrot, Jan A. Staessen, Godsent C. Isiguzo, Augustine N. Odili\r\n<\/div>        \r\n<\/div>                                                                                                                            \r\n            <div id=\"copyright\">\r\n        <strong>Copyright:<\/strong> Clinics Cardive Publishing (Pty) Ltd. publisher\r\n        of Cardiovascular Journal of Africa.<\/div>\r\n    <div style=\"clear: both;\"><\/div>                                                                                                                                \r\n        <div id=\"article-abstract\">                                                                                                            \r\n            <div id=\"abstract-title\">                                                                                                        \r\n                    Abstract                                                                                                                \r\n                <\/div>                                                                                                                        \r\n                                                                                                                                \r\n            <div id=\"abstract-content\">                                                                                                        \r\n            <!--Content of Abstract Article-->                                                                                                \r\n            <!--<strong>\"Abstract titles\":<\/strong>-->                                                                                        \r\n            <!--<br\/> at the end of each section!!-->                                                                                        \r\n                                                                                                                                                     \r\n\r\n        <strong>Background:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nEchocardiography is the guideline- recommended tool for risk stratification in asymptomatic high-risk patients, but its reproducibility in sub-Saharan Africa remains largely undocumented. This study assessed the intra- and inter-rater repeatability of the risk-carrying echocardiographic traits among 42 patients enrolled in the UPRIGHT-HTM trial at three Nigerian sites.\r\n<br \/>   \r\n\r\n        <strong>Methods:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThe echocardiographic images (168 for intra- and 84 for inter-rater agreement) were acquired according to current recommendations and blindly analysed by randomising the order of the digitised images. The study focused on left ventricular mass (LVM) index to body surface area of height 2.7 and ejection fraction (EF) and left ventricular diastolic dysfunction (LVDD). Repeatability was assessed by the Bland and Altman approach, the coefficient of variation (CV), the intra-class correlation coefficient (ICC) and Cohen's k statistic. The current findings were compared with a systematic literature review of 27 publications.\r\n<br \/>\r\n                \r\n                <strong>Results:<\/strong>                                                                                                    \r\nLVM showed a slight but significant intra-rater bias, but no inter-rater bias. CVs for LVM were approximately 30%, ICCs ranged from 0.74 to 0.84, and k statistics for LV hypertrophy (LVH) varied from 0.49 to 0.64. For EF, intra- and inter-rater CVs ranged from 13.0% to 14.5%, ICCs from 0.60 to 0.69, and statistics were 0.71 and 0.53, respectively. LVDD reproducibility was moderate, with \u03ba values around 0.50. These findings were consistent with most of the reviewed literature.\r\n<br \/>\r\n                                                                                                                                                                                                                                                                        \r\n                                                                                                                                                \r\n        <strong>Conclusion:<\/strong>                                                                                                    \r\n                                                                                                                                                    \r\nThe risk-carrying echocardiographic traits were obtained with moderate repeatability in three Nigerian tertiary referral centres. As data quality augments with expertise, these findings call for a Nigerian training programme in echocardiography with certification.\r\n<br \/>    \r\n                                                                                                        \r\n\r\n                                                                                                                                                \r\n            <\/div>                                                                                                                            \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                        \r\n                                                                                                                                                \r\n        <div id=\"keywords\">                                                                                                                    \r\n                                                                                                                                            \r\n            <strong>Keywords:<\/strong>                                                                                                        \r\n                                                                                                                                            \r\n            <strong>echocardiography, heart, left ventricle, randomised clinical trial, reproducibility, sub-Saharan Africa<\/strong>                                                                                                                                                                                                                    \r\n                                                                                                                                                \r\n        <\/div>                                                                                                                                    \r\n                                                                                                                                                \r\n    <div id=\"publish-info\">                                                                                                                    \r\n                                                                                                                                \r\n    <strong>Submitted:<\/strong> July 26, 2024; <!--Month day, year; -->    \r\n    <strong>Accepted:<\/strong> July 10, 2025; <!--Month day, year; -->                                                                            \r\n    <strong>Published:<\/strong> March 13, 2026<!--Month day, year; -->                                                                                                                            <br \/>                                                            \r\n        <em>Cardiovasc J Afr 2025; <b>37<\/b>: 86-101<!--pg no. till pg no. \"eg. 4-7\"--><\/em>\r\n        <br \/><strong>Volume 37, Issue 1<\/strong> <br \/>                                                                            \r\n        <\/div>                                                                                                                            \r\n                                                                                                                                        \r\n    <div id=\"DOI\">                                                                                                                    \r\n            DOI Citation Reference: dx.doi.org\/10.5830\/CVJA-2025-114<!--DOI number-->                                                                \r\n        <\/div>                                                                                                                            \r\n                \r\n                <div id=\"author-affiliation\">                                                                                                \r\n\r\n\r\n<strong>Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium\r\n<\/strong>    <br \/>                                                                            \r\nBabangida S. Chori<br \/>  \r\nDries S. Martens<br \/>  \r\nTim S. Nawrot\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Circulatory Health Research Laboratory, College of Health Sciences, University of Abuja\r\n<\/strong>    <br \/>                                                                            \r\nBabangida S. Chori<br \/>  \r\nAugustine N. Odili\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Research Association Alliance for the Promotion of Preventive Medicine, Mechelen, Belgium\r\n<\/strong>    <br \/>                                                                            \r\nBabangida S. Chori<br \/>\r\nDong-Yan Zhang<br \/>\r\nYu-Ling Yu<br \/>\r\nDe-Wei An<br \/>\r\nJan A. Staessen\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden\r\n<\/strong>    <br \/>                                                                            \r\nYu-Ling Yu\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Cardiovascular Medicine, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China\r\n<\/strong>    <br \/>                                                                            \r\nDong-Yan Zhang<br \/>\r\nDe-Wei An<br \/>\r\nJan A. Staessen\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Divisions of Cardiology and Endocrinology, Department of Internal Medicine, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria\r\n<\/strong>    <br \/>                                                                            \r\nSamuel E. Antia<br \/>\r\nCollins N. Ugwu<br \/>\r\nChidiebere V. Ugwueze<br \/>\r\nGodsent C. Isiguzo\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Internal Medicine, Faculty of Clinical Sciences, College of Health Sciences, University of Abuja, Nigeria\r\n<\/strong>    <br \/>                                                                            \r\nOjonoma Ajanya\r\nAugustine N. Odili\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Industrial Mathematics and Applied Statistics, Faculty of Physical Science, Ebonyi State University\r\n<\/strong>    <br \/>                                                                            \r\nArinze F. Obasi\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Internal Medicine, Federal Medical Centre Jabi, Abuja, Nigeria\r\n<\/strong>    <br \/>                                                                            \r\nOlugbenga O. Abiodun\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Department of Internal Medicine, Federal Teaching Hospital, Katsina, Nigeria\r\n<\/strong>    <br \/>                                                                            \r\nMuhammad N. Shehu<br \/>\r\nBushra M. Sanni<br \/>\r\nSanusi Garba\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Research Unit Environment and Health, KU Leuven, Department of Public Health and Primary Care, University of Leuven, Leuven, Belgium\r\n<\/strong>    <br \/>                                                                            \r\nYu-Ling Yu\r\n\r\n<br \/><br \/>\r\n\r\n<strong>First Department of Cardiology, International Electrocardiology and Hypertension, Jagiellonian University Medical College, Krak\u00f3w, Poland\r\n<\/strong>    <br \/>                                                                            \r\nStolarz-Skrzypek<br \/>\r\nMarek Rajzer<br \/>\r\nJan A. Staessen\r\n\r\n<br \/><br \/>\r\n\r\n<strong>Biomedical Sciences Group, Faculty of Medicine, University of Leuven, Leuven, Belgium\r\n<\/strong>    <br \/>                                                                            \r\nJan A. Staessen\r\n\r\n<br \/><br \/>\r\n                                                                                                                                                                                                                                        \r\n\r\n                [soshsc hide=\"logged\"]\r\n                <strong>You need to be <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/member-login\/\" target=\"_blank\" rel=\"noopener\">logged in to view and download<\/a> the full text PDF version. <a style=\"color: #c80c44;\" href=\"https:\/\/cvja.co.za\/journal\/register\/\" target=\"_blank\" rel=\"noopener\">Register for a free account?<\/a><\/strong> <br \/><br \/>[\/soshsc]\r\n                \r\n                \r\n                \r\n                <\/div>\r\n    \r\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Echocardiography is the guideline- recommended tool for risk stratification in asymptomatic high-risk patients, but its reproducibility in sub-Saharan Africa remains largely undocumented. This study assessed the intra- and inter-rater repeatability of the risk-carrying echocardiographic traits among 42 patients enrolled in the UPRIGHT-HTM trial at three Nigerian sites.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[44,109],"tags":[],"class_list":["post-5421","post","type-post","status-publish","format-standard","hentry","category-cardiovascular-topics","category-volume-37-issue-1"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.0 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Intra- and inter-rater reproducibility of the echocardiographic data of the Nigerian UPRIGHT-HTM trial participants - Cardiovascular Journal of Africa<\/title>\n<meta name=\"description\" content=\"Echocardiography is the guideline- recommended tool for risk stratification in asymptomatic high-risk patients, but its reproducibility in sub-Saharan Africa remains largely undocumented. 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