Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study.

IF 3.6 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Marina Del Rios, Joseph Colla, Pavitra Kotini-Shah, Joan Briller, Ben Gerber, Heather Prendergast
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引用次数: 15

Abstract

Introduction: This study evaluates the agreement between emergency physician (EP) assessment of diastolic dysfunction (DD) by a simplified approach using average peak mitral excursion velocity (e'A) and an independent cardiologist's diagnosis of DD by estimating left atrial (LA) pressure using American Society of Echocardiography (ASE) guidelines.

Methods: This 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 e'A < 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.

Results: Six 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.

Conclusion: There is a good agreement between (e'A) 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.

急诊医师使用组织多普勒床边超声心动图检测舒张功能障碍:一项探索性研究。
简介:本研究评估急诊医师(EP)使用二尖瓣平均峰值偏移速度(e'A)的简化方法对舒张功能障碍(DD)的评估与独立心脏病专家使用美国超声心动图学会(ASE)指南通过估计左心房(LA)压力对DD的诊断之间的一致性。方法:这是对48张有限床边超声心动图(LBE)的二次分析,作为一项研究研究的一部分,这些患者在急诊科(ED)出现血压升高,但没有失代偿性心力衰竭。结果:6例LBEs被心脏病专家认为是不确定的,并被排除在分析之外。48件中有41件(85.4%)达成了协议。未加权kappa系数为0.74 (95% CI 0.57 ~ 0.92)。在心脏病专家诊断为舒张功能障碍的20名lbe患者中,EPs识别出18名。结论:EP的e'A值与心内科医生对LBEs的解释有很好的一致性。未来的研究应该将这种简化的方法作为筛选ED中左室舒张功能障碍的一步方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Critical Ultrasound Journal
Critical Ultrasound Journal RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
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审稿时长
13 weeks
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