{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T21:02:26Z","timestamp":1767646946441,"version":"3.48.0"},"reference-count":23,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Sciences and Higher Education of the Republic of Kazakhstan","award":["AP23490021"],"award-info":[{"award-number":["AP23490021"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The pressure-volume (PV) relationship remains a key tool for assessing cardiac function. PV loop derived parameters, including end-systolic elastance (Ees), effective arterial elastance (Ea), ventriculo-arterial coupling (VAC), stroke work (SW), pressure-volume area (PVA), and work efficiency (WE), are valuable tools, but reproducibility data are scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the inter- and intra-observer variability of PV loop parameters derived from transthoracic echocardiography images in patients undergoing hemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty-five adult patients with end-stage renal disease undergoing maintenance hemodialysis were randomly selected. PV loops were reconstructed using Q-Strain software (version 1.3.0.79, Medis, Leiden, the Netherlands), and parameters including Ees, Ea, VAC, SW, PVA, and WE were calculated. Two experienced readers performed measurements for inter-observer analysis; one reader repeated measurements one week apart for intra-observer analysis. Reliability was assessed using intraclass correlation coefficients (ICC) and Bland-Altman plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Inter-observer agreement was excellent for SW 0.96 (0.91\u20130.98) and PVA 0.95 (0.87\u20130.98), good for Ees 0.90 (0.77\u20130.96) and Ea 0.79 (0.49\u20130.91), and moderate for VAC 0.68 (0.23\u20130.85) and WE 0.72 (0.28\u20130.79). Intra-observer agreement was excellent for Ees 0.96 (0.90\u20130.98), Ea 0.98 (0.94\u20130.99), SW 0.98 (0.96\u20130.99) and PVA 0.98 (0.96\u20130.99), and good for VAC 0.78 (0.51\u20130.91) and WE 0.85 (0.65\u20130.94). Bland-Altman analysis showed minimal bias for Ees, SW and PVA, whereas Ea, VAC and WE exhibited proportional bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PV loop-derived parameters obtained via transthoracic echocardiography demonstrate good-to-excellent reproducibility, particularly for Ees, Ea, SW and PVA. VAC and WE show moderate variability, suggesting careful interpretation of these parameters in clinical and research settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0340206","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T18:45:37Z","timestamp":1767638737000},"page":"e0340206","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability of pressure-volume loop parameters derived from transthoracic echocardiography in patients undergoing hemodialysis"],"prefix":"10.1371","volume":"21","author":[{"given":"Dinara","family":"Galiyeva","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaukiya","family":"Khamitova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aizhan","family":"Zhankorazova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayan","family":"Nurkesh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinara","family":"Jumadilova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bauyrzhan","family":"Toktarbay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Murat","family":"Mukarov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexey","family":"Kokoskho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abduzhappar","family":"Gaipov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4596-0887","authenticated-orcid":true,"given":"Alessandro","family":"Salustri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"issue":"12","key":"pone.0340206.ref001","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.1093\/eurheartj\/ehz552","article-title":"Invasive left ventricle pressure-volume analysis: overview and practical clinical implications","volume":"41","author":"MB Bastos","year":"2020","journal-title":"Eur Heart J"},{"key":"pone.0340206.ref002","doi-asserted-by":"crossref","DOI":"10.1016\/j.yjmcc.2018.04.017","article-title":"Rediscovery of Otto Frank\u2019s contribution to science","volume":"119","author":"JP Kuhtz-Buschbeck","year":"2018","journal-title":"J Mol Cell Cardiol"},{"key":"pone.0340206.ref003","article-title":"Noninvasive assessment of left ventricular performance using pressure\u2013volume loops, blood propulsion and strain tensors: results from the World Alliance of Societies of Echocardiography study","author":"G Pedrizzetti","year":"2025","journal-title":"Eur Heart J - Cardiovasc Imaging"},{"issue":"4","key":"pone.0340206.ref004","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1002\/ejhf.1436","article-title":"The role of ventricular-arterial coupling in cardiac disease and heart failure: assessment, clinical implications and therapeutic interventions. 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