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

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

doi:10.1186/s13089-018-0084-5

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

Journal article

Open access

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

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

Critical ultrasound journal, Vol.10(1), pp.4-4

01/25/2018

DOI: 10.1186/s13089-018-0084-5

PMCID: PMC5785451

PMID: 29372430

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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.

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Details

Title: Subtitle: Emergency physician use of tissue Doppler bedside echocardiography in detecting diastolic dysfunction: an exploratory study
Creators: Marina Del Rios - University of Illinois Chicago
Joseph Colla - University of Illinois Chicago
Pavitra Kotini-Shah - University of Illinois Chicago
Joan Briller - University of Illinois Chicago
Ben Gerber - University of Illinois Chicago
Heather Prendergast - University of Illinois Chicago
Resource Type: Journal article
Publication Details: Critical ultrasound journal, Vol.10(1), pp.4-4
DOI: 10.1186/s13089-018-0084-5
PMID: 29372430
PMCID: PMC5785451
NLM abbreviation: Crit Ultrasound J
ISSN: 2036-3176
eISSN: 2036-7902
Publisher: Springer Milan
Language: English
Date published: 01/25/2018
Academic Unit: Emergency Medicine
Record Identifier: 9984297149602771

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