Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study
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 (eʹA) and an independent cardiologist’s diagnosis of DD by estimating left atrial (LA) pressure usi...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-01-01
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| Series: | Critical Ultrasound Journal |
| Online Access: | http://link.springer.com/article/10.1186/s13089-018-0084-5 |
| _version_ | 1818658491655520256 |
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| author | Marina Del Rios Joseph Colla Pavitra Kotini-Shah Joan Briller Ben Gerber Heather Prendergast |
| author_facet | Marina Del Rios Joseph Colla Pavitra Kotini-Shah Joan Briller Ben Gerber Heather Prendergast |
| author_sort | Marina Del Rios |
| collection | DOAJ |
| description | 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 (eʹA) 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 eʹA < 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 (eʹA) 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. |
| first_indexed | 2024-12-17T03:58:13Z |
| format | Article |
| id | doaj.art-b7e2f00865fa4af7be849897ff3aa6b3 |
| institution | Directory Open Access Journal |
| issn | 2036-3176 2036-7902 |
| language | English |
| last_indexed | 2024-12-17T03:58:13Z |
| publishDate | 2018-01-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Critical Ultrasound Journal |
| spelling | doaj.art-b7e2f00865fa4af7be849897ff3aa6b32022-12-21T22:04:34ZengSpringerOpenCritical Ultrasound Journal2036-31762036-79022018-01-011011310.1186/s13089-018-0084-5Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory studyMarina Del Rios0Joseph Colla1Pavitra Kotini-Shah2Joan Briller3Ben Gerber4Heather Prendergast5Department of Emergency Medicine, University of Illinois at ChicagoDepartment of Emergency Medicine, University of Illinois at ChicagoDepartment of Emergency Medicine, University of Illinois at ChicagoDepartment of Cardiology, University of Illinois at ChicagoDepartment of Internal Medicine, University of Illinois at ChicagoDepartment of Emergency Medicine, University of Illinois at ChicagoAbstract 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 (eʹA) 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 eʹA < 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 (eʹA) 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.http://link.springer.com/article/10.1186/s13089-018-0084-5 |
| spellingShingle | Marina Del Rios Joseph Colla Pavitra Kotini-Shah Joan Briller Ben Gerber Heather Prendergast Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study Critical Ultrasound Journal |
| title | Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study |
| title_full | Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study |
| title_fullStr | Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study |
| title_full_unstemmed | Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study |
| title_short | Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study |
| title_sort | emergency physician use of tissue doppler bedside echocardiography in detecting diastolic dysfunction an exploratory study |
| url | http://link.springer.com/article/10.1186/s13089-018-0084-5 |
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