For the non-cardiologist emergency physician and intensivist, performing an accurate estimation of left ventricular ejection fraction (LVEF) is essential for the management of critically ill patients, such as patients presenting with shock, severe respiratory distress or chest pain. Our objective was to develop a semi-quantitative method to improve visual LVEF evaluation. A group of 12 sets of transthoracic echocardiograms with LVEF in the range of 18–64% were interpreted by 17 experienced observers (PRO) and 103 untrained observers or novices (NOV), without previous training in echocardiography. They were asked to assess LVEF by two different methods: i) visual estimation (VIS) by analysing the three classical left ventricle (LV) short-axis views (basal, midventricular and apical short-axis LV section) and ii) semi-quantitative evaluation (base, mid and apex (BMA)) of the same three short-axis views. The results for each of these two methods for both groups (PRO and NOV) were compared with LVEF obtained by radionuclide angiography. The semi-quantitative method (BMA) improved estimation of LVEF by PRO for moderate LV dysfunction (LVEF 30–49%) and normal LVEF. The visual estimate was better for lower LVEF (<30%). In the NOV group, the semi-quantitative method was better than than the visual one in the normal group and in half of the subjects in the moderate LV dysfunction (LVEF 30–49%) group. The visual estimate was better for the lower LVEF (ejection fraction <30%) group. In conclusion, semi-quantitative evaluation of LVEF gives an overall better assessment than VIS for PRO and untrained observers.
Backgrounds. For emergency physicians performing a goal-directed transthoracic echocardiogram (TTE), a reliable estimate of LVEF must be obtained rapidly. We compared rapid LVEF estimates obtained from short axis sections to those obtained from apical sections using two methods of evaluation. Methods. The TTE's of 6 patients were interpreted by 16 echo-proficient readers (PRO group) and 105 novice readers (NOV group). LVEF was assessed by each group. The strategies consisted of either a global visual estimation (VIS) of LVEF or semiquantitative (SQ) methods. Results. Using RNV and BIP as a reference standard, NOV readers performed better with the SQ method than global visual estimation. For NOV readers, best agreement was achieved with the 234C sequence in low LVEF situations, but with the BMA series in normal LVEF settings. Neither series of views was better than the other in the setting of mild LVEF depression. Conclusion. Semi-quantitative method was superior to global visual estimation of LVEF in NOV group in most of the LVEF ranges.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.