2031a cohorts were entirely male, whereas the SEROCO cohort included 22% females), HIV risk category (26% heterosexual and 7% intravenous drug abuse in SEROCO, versus none in the NA cohorts; 22% hemophiliacs in the NA cohorts, versus none in SEROCO), and median length of patient follow-up (73 months for SE-ROCO versus 89 months for NA cohorts). Cohort differences have also been observed for other HIV disease-associated chemokine and chemokine receptor variants (4 -10). Nevertheless, at present, the results from this study and from that of Faure et al.(1), taken together, do not support a clear and consistent role for CX 3 CR1 in HIV pathogenesis.
IntroductionThis study evaluates the agreement between emergency physician (EP) assessment of diastolic dysfunction (DD) by a simplified approach using average peak mitral excursion velocity (eʹA) and an independent cardiologist’s diagnosis of DD by estimating left atrial (LA) pressure using American Society of Echocardiography (ASE) guidelines.MethodsThis was a secondary analysis of 48 limited bedside echocardiograms (LBE) performed as a part of a research study of patients presenting to the Emergency Department (ED) with elevated blood pressure but without decompensated heart failure. EPs diagnosed DD based on eʹA < 9 cm/s alone. A blinded board-certified cardiologist reviewed LBEs to estimate LA filling pressures following ASE guidelines. An unweighted kappa measure was calculated to determine agreement between EP and cardiologist.ResultsSix LBEs were deemed indeterminate by the cardiologist and excluded from the analysis. Agreement was reached in 41 out of 48 cases (85.4%). The unweighted kappa coefficient was 0.74 (95% CI 0.57–0.92). EPs identified 18 out of 20 LBEs diagnosed with diastolic dysfunction by the cardiologist.ConclusionThere is a good agreement between (eʹA) by EP and cardiologist interpretation of LBEs. Future studies should investigate this simplified approach as a one-step method of screening for LV diastolic dysfunction in the ED.
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