P791Non-expert assessment of left ventricular systolic function using pocket-sized ultrasound


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Abstract

Purpose: The aim of this study was to investigate if general practitioners were able to evaluate left ventricular systolic function by using a pocket-sized ultrasound scanner with b-mode and color flow Doppler.Methods: 92 patients were included. They had one of the following characteristics: systolic heart failure, earlier myocardial heart infarction or known arterial hypertension. 7 general practitioners (in 3 different offices) had a total of one day of training before they examined their own patients using a pocket-sized scanner. There was no selection according to echogenicity. The scan was done as part of a routine appointment and was scheduled for no more than 5 minutes. A cardiologist examined the patients less than 30 minutes afterwards, both with a high-end scanner and a pocket-sized scanner. To evaluate the left ventricular systolic function we used the Mitral annular excursion. This was measured both by the GP (pocket-sized) and the cardiologist (pocket-sized and high-end scanner).The Spearman's rank correlation coefficients r was calculated.Results: In 80 (87 %) of patients the GPs were able to obtain a 4 chamber view recording and measure the septal mitral annular excursion. When comparing the pocket-sized recordings and measurement of septal mitral annular excursion made by the GP vs a cardiologist the correlation coefficient was high, r = 0.78 and the 95 % limits of agreement was -0.26 ± 3.02 mm. When a second cardiologist repeated the measurements on the recordings made by the GPs and compared it to the first cardiologist the correlation increased to r = 0.82. Comparing measurements from the two different scanners both operated by the cardiologist the correlation coefficient was very high r = 0.89 with 95 % limits of agreement 0.11 ± 1.98 mm.Conclusions: General practitioners were in less than 5 minutes able to get important diagnostic and prognostic knowledge of their patients by using a pocket-sized ultrasound scanner. More training can increase both the quality of the recordings and measurements. When used by a cardiologist the pocket-sized scanner offers the same accuracy when evaluating the septal mitral annular excursion as a high-end scanner.

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