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

Overview of attention for article published in The Ultrasound Journal, January 2018
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Title
Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study
Published in
The Ultrasound Journal, January 2018
DOI 10.1186/s13089-018-0084-5
Pubmed ID
Authors

Marina Del Rios, Joseph Colla, Pavitra Kotini-Shah, Joan Briller, Ben Gerber, Heather Prendergast

Abstract

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. 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. 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. 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.

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Geographical breakdown

Country Count As %
Unknown 24 100%

Demographic breakdown

Readers by professional status Count As %
Other 6 25%
Professor > Associate Professor 4 17%
Researcher 3 13%
Librarian 2 8%
Lecturer 1 4%
Other 4 17%
Unknown 4 17%
Readers by discipline Count As %
Medicine and Dentistry 16 67%
Agricultural and Biological Sciences 1 4%
Social Sciences 1 4%
Sports and Recreations 1 4%
Unknown 5 21%