Title |
Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study
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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. |
X Demographics
Geographical breakdown
Country | Count | As % |
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United States | 10 | 37% |
Spain | 2 | 7% |
United Kingdom | 2 | 7% |
China | 1 | 4% |
Costa Rica | 1 | 4% |
New Zealand | 1 | 4% |
Thailand | 1 | 4% |
Mexico | 1 | 4% |
Canada | 1 | 4% |
Other | 0 | 0% |
Unknown | 7 | 26% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 14 | 52% |
Members of the public | 12 | 44% |
Scientists | 1 | 4% |
Mendeley readers
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% |