Diagnostic accuracy of pocket-size handheld echocardiographs used by cardiologists in the acute care setting

Testuz, Ariane; Müller, Hajo; Keller, Pierre-Frédéric; Meyer, Philippe; Stampfli, Tomoe; Šekoranja, Lučka; Vuille, Cédric; Burri, Haran

doi:10.1093/ehjci/jes085

Cited by 72 publications

(66 citation statements)

References 12 publications

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“…[131][132][133][134][135] The incremental value of point-of-care echocardiography seems to be greatest for the diagnosis of LV systolic dysfunction. 136,137 Moreover, the demonstration of LVH in a patient presenting with dyspnea can be an important corroborative finding.…”

Section: Recent Technological Innovations Miniaturization and Remote mentioning

confidence: 99%

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Omar

Bansal

Sengupta

2016

Circulation Research

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Echocardiography, given its safety, easy availability, and the ability to permit a comprehensive assessment of cardiac structure and function, is an indispensable tool in the evaluation and management of patients with heart failure (HF). From initial phenotyping and risk stratification to providing vital data for guiding therapeutic decision-making and monitoring, echocardiography plays a pivotal role in the care of HF patients. The recent advent of multiparametric approaches for myocardial deformation imaging has provided valuable insights in the pathogenesis of HF, elucidating distinct patterns of myocardial dysfunction and events that are associated with progression from subclinical stage to overt HF. At the same time, miniaturization of echocardiography has further expanded clinical application of echocardiography, with the use of pocket cardiac ultrasound as an adjunct to physical examination demonstrated to improve diagnostic accuracy and risk stratification. Furthermore, ongoing advances in the field of big data analytics promise to create an exciting opportunity to operationalize precision medicine as the new approach to healthcare delivery that aims to individualize patient care by integrating data extracted from clinical, laboratory, echocardiographic, and genetic assessments. evidence supporting the diagnosis of HF. Echocardiography is the most commonly used modality for this purpose because of its ease of application, noninvasive nature, safety, and ability to provide a vast amount of information about cardiac structure and function. Additionally, echocardiography also plays an important role in guiding therapeutic decision-making and in monitoring response to therapy. Over the past 3 decades, numerous advancements have occurred in the field of echocardiography that have helped improve our understanding of the morpho-functional aberrations occurring in HF. This review summarizes the recent advances in echocardiography as applicable to the evaluation and management of HF. Classification of Heart FailureTo facilitate clinical management, several attempts have been made to divide HF patients into categories that unify them according to their dominant clinical presentations. Thus, HF has often been described as low output failure or high output failure; forward failure or backward failure; systolic HF or diastolic HF; HFrEF or HF with preserved ejection fraction (HFpEF); and so on. More recently, HF has also been classified according to alterations in the mechanical function of the left ventricle (LV; Table 1). 6The classification of HF into systolic or diastolic HF appeared to be intuitive, categorizing patients based on the primary pathogenic abnormality, that is, impairment of cardiac contractility or impairment of filling. However, this description has now been abandoned with the recognition that these 2 entities are not mutually exclusive and have considerable overlap. Significant LV diastolic dysfunction is a ubiquitous occurrence in patients with systolic HF, whereas systolic dysfunction...

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Section: Recent Technological Innovations Miniaturization and Remote mentioning

confidence: 99%

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Omar

Bansal

Sengupta

2016

Circulation Research

View full text Add to dashboard Cite

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“…A quick-scan is suited to acute settings, including the acute medical unit, inpatients, 7,11-13 emergency department, 8 cardiac arrests, intensive care, 14,15 the perioperative period, 5 and special situations, such as mobile medical units, disaster zones and battle zones. 4,[15][16][17][18] In cardiac arrest, a quick-scan can identify or indicate the presence of reversible causes of pulseless electrical activity (PEA), and distinguish true PEA, which carries a worse prognosis, from pseudo-PEA. 19,20 A quick-scan can be used to triage those who need a standard echocardiogram and contributes to clinical risk stratifi cation.…”

Section: Clinical Applications Advantages and Limitations In Acute Mmentioning

confidence: 99%

“…A quick-scan is not a standard echocardiogram and it has limitations. It is inferior at assessing LV dimensions, 18 RV function and mitral regurgitation, 18 and cannot assess diastolic function. For emergency triage, it performs well when used by operators trained in standard echocardiography, but there are few data for operators trained solely to the level of a quick-scan save for one small study in medical students.…”

Section: Clinical Applications Advantages and Limitations In Acute Mmentioning

confidence: 99%

Point-of-care cardiac ultrasound in acute medicine – the quick scan

2014

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Point-of-care cardiac ultrasound in acute medicine -the quick scanThe optimum management of acute medical patients requires prompt and accurate diagnosis, monitoring and treatment. The clinical history and physical examination remain central to diagnosis, but often need supplementation by laboratory testing or imaging. Echocardiographic assessment of cardiac structure and function provides valuable information that can aid diagnosis and assess clinical progress. It has many advantages as an imaging modality, and recent technological advances have resulted in hand-held, battery-powered ultrasound devices that provide high-quality images. Three broad applications of cardiac ultrasound now exist: conventional echocardiography, focussed echocardiography and the quick-scan. A quick-scan using a hand-held ultrasound device is readily integrated into the bedside clinical assessment, providing information that can be used immediately in diagnostic reasoning; it can also guide pericardiocentesis. Hand-held ultrasound devices can also be used in acute situations, as well as geographically remote areas or special situations (eg disaster zones) where other imaging is not available. However, the diagnostic yield of echocardiography is user dependent, and training is required for its benefi ts to be realised, adding to the hardware costs. More data are needed on the incremental value of hand-held ultrasonography and a quickscan over conventional methods of assessment, their impact on clinical outcomes, and cost effectiveness.

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“…Pocket-sized ultrasound devices are powerful tools that have been found to perform similarly to traditional high-end systems when used by experienced clinicians. [5][6][7][8][9][10][11][12][13] Internal medicine residents desire ultrasound training, but self-reported competence is low. 14 Several studies have shown that after brief training, residents can become competent in performing and interpreting basic ultrasound examinations.…”

Section: Introductionmentioning

confidence: 99%

Pocket-Sized Ultrasound as an Aid to Physical Diagnosis for Internal Medicine Residents: A Randomized Trial

et al. 2014

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Diagnostic accuracy of pocket-size handheld echocardiographs used by cardiologists in the acute care setting

Abstract: The Vscan used by a trained cardiologist has good diagnostic accuracy in the emergency setting compared with a high-end echocardiograph, despite small screen size and lack of pulse-wave and continuous Doppler.

Cited by 72 publications

References 12 publications

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Advances in Echocardiographic Imaging in Heart Failure With Reduced and Preserved Ejection Fraction

Point-of-care cardiac ultrasound in acute medicine – the quick scan

Pocket-Sized Ultrasound as an Aid to Physical Diagnosis for Internal Medicine Residents: A Randomized Trial

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