Impact of experience on visual and Simpson's biplane echocardiographic assessment of left ventricular ejection fraction.

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging Pub Date : 2024-12-02 DOI:10.1111/cpf.12918

S Akil, J Castaings, P Thind, T Åhlfeldt, M Akhtar, A T Gonon, M Quintana, K Bouma

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引用次数: 0

Abstract

Background: In clinical routine, health care professionals with various levels of experience assess left ventricular ejection fraction (LVEF) by echocardiography. The aim was to investigate to what extent visual and Simpson's biplane assessment of LVEF, using two-dimensional (2D) transthoracic echocardiography (TTE), is affected by the evaluator's experience.

Methods: Ultrasound images of 140 patients were assessed, visually and with Simpson's biplane method, by six evaluators divided into three groups based on echocardiographic experience level (beginner, intermediate and expert). The evaluators were blinded to each other's LVEF assessments. Bland-Altman analyses (bias±SD) were performed to assess agreement. P-values < 0.05 with the performed paired t-test were considered statistically significant.

Results: Level of agreement in LVEF was good between evaluators within the expert group: visual = LVEF_{expert 1} vs LVEF_{expert 2}: -0.4 ± 6.4 (p = 0.46); Simpson's biplane = LVEF_{expert 1} vs LVEF_{expert 2}: 0.96 ± 7.0 (p = 0.11), somewhat lower within the intermediate group: visual = LVEF_{intermediate 1} vs LVEF_{intermediate 2}: -1.2 ± 4.4 (p = 0.004); Simpson's biplane = LVEF_{intermediate 1} vs LVEF _{intermediate 2}: -3.3 ± 5.0 (p < 0.001) and lowest for beginners: visual = LVEF_{beginner 1} vs LVEF_{beginner 2}: 2.3 ± 9.8 (p = 0.007), Simpson's biplane = LVEF_{beginner 1} vs LVEF beginner 2: -1.8 ± 8.7 (p = 0.02). The agreement between LVEF_expert and LVEFs by the two other groups was: visual = LVEF_expert vs LVEF_beginner: 1.5 ± 6.0 (p = 0.005); LVEF_intermediate: -3.0 ± 4.4 (p < 0.001) and Simpson's biplane = LVEF_expert vs LVEF_beginner: 3.2 ± 6.3 (p < 0.001); LVEF_intermediate: -2.2 ± 4.7 (p < 0.001).

Conclusions: The evaluator's level of experience affects visual and Simpson's biplane assessment of LVEF by 2D-TTE, with highest variability being among beginners. Furthermore, a second opinion is recommended when assessing reduced LVEF even for evaluators with intermediate and expert experience.

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.