The use of handheld ultrasound devices: a position statement of the European Association of Cardiovascular Imaging (2018 update)

Cardim, Nuno; Dalen, Håvard; Voigt, Jens‐Uwe; Ionescu, Adrian; Price, Susanna; Neskovic, Alexsandar N.; Edvardsen, Thor; Galderisi, Maurizio; Sicari, Rosa; Donal, Erwan; Stefanidis, Alexandros; Delgado, Victoria; Zamorano, José; Popescu, Bogdan A

doi:10.1093/ehjci/jey145

Cited by 105 publications

(94 citation statements)

References 79 publications

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“…As recently recommended, focused echocardiography is needed in a case of haemodynamic instability in pre‐hospital or at hospital admission to identify or eliminate cardiac cause(s) ( Figure ). FoCUS represents a rapid problem‐oriented point‐of‐care protocol for the emergency department usually limited to subcostal long‐axis and inferior vena cava views, parasternal long and short‐axis and apical four‐chamber views. FoCUS is possible to carry out with portable or handheld devices as an adjunct to physical examination, utilizing two‐dimensional and colour‐Doppler methods.…”

Section: Imaging In the Urgent Phase: Heart Failure‐oriented Focused mentioning

confidence: 99%

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Čelutkienė

Lainščak

Anderson

et al. 2019

European J of Heart Fail

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Acute heart failure is one of the main diagnostic and therapeutic challenges in clinical practice due to a non‐specific clinical manifestation and the urgent need for timely and tailored management at the same time. In this position statement, the Heart Failure Association aims to systematize the use of various imaging methods in accordance with the timeline of acute heart failure care proposed in the recent guidelines of the European Society of Cardiology. During the first hours of admission the point‐of‐care focused cardiac and lung ultrasound examination is an invaluable tool for rapid differential diagnosis of acute dyspnoea, which is highly feasible and relatively easy to learn. Several portable and stationary imaging modalities are being increasingly used for the evaluation of cardiac structure and function, haemodynamic and volume status, precipitating myocardial ischaemia or valvular abnormalities, and systemic and pulmonary congestion. This paper emphasizes the central role of the full echocardiographic examination in the identification of heart failure aetiology, severity of cardiac dysfunction, indications for specific heart failure therapy, and risk stratification. Correct evaluation of cardiac filling pressures and accurate prognostication may help to prevent unscheduled short‐term readmission. Alternative advanced imaging modalities should be considered to assist patient management in the pre‐ and post‐discharge phase, including cardiac magnetic resonance, computed tomography, nuclear studies, and coronary angiography. The Heart Failure Association addresses this paper to the wide spectrum of acute care and heart failure specialists, highlighting the value of all available imaging techniques at specific stages and in common clinical scenarios of acute heart failure.

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Section: Imaging In the Urgent Phase: Heart Failure‐oriented Focused mentioning

confidence: 99%

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Čelutkienė

Lainščak

Anderson

et al. 2019

European J of Heart Fail

View full text Add to dashboard Cite

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“…As mentioned, examinations using hand-held ultrasound devices are generally interpreted visually [15]. The use of quantitative measures may improve the diagnostic yield and is recommended [16].…”

Section: Discussionmentioning

confidence: 99%

“…However, diagnostics was not the purpose of the study, and we do not recommend performing diagnostic ultrasound with such limited training. In line with the European Association of Cardiovascular Imaging's (EACVI) viewpoint on education for focused cardiac ultrasound, the students should have been trained until they had reached an adequate [15,16]. This may not require much resources in terms of teachers.…”

Section: Discussionmentioning

confidence: 99%

Automatic quantification of left ventricular function by medical students using ultrasound

et al. 2020

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Background: Automatic analyses of echocardiograms may support inexperienced users in quantifying left ventricular (LV) function. We have developed an algorithm for fully automatic measurements of mitral annular plane systolic excursion (MAPSE) and mitral annular systolic (S′) and early diastolic (e′) peak velocities. We aimed to study the influence of user experience of automatic measurements of these indices in echocardiographic recordings acquired by medical students and clinicians. Methods: We included 75 consecutive patients referred for echocardiography at a university hospital. The patients underwent echocardiography by clinicians (cardiologists, cardiology residents and sonographers), who obtained manual reference measurements of MAPSE by M-mode and of S′ and e′ by colour tissue Doppler imaging (cTDI). Immediately after, each patient was examined by 1 of 39 medical students who were instructed in image acquisition on the day of participation. Each student acquired cTDI recordings from 1 to 4 patients. All cTDI recordings by students and clinicians were analysed for MAPSE, S′ and e′ using a fully automatic algorithm. The automatic measurements were compared to the manual reference measurements. Results: Correct tracking of the mitral annulus was feasible in 50 (67%) and 63 (84%) of the students' and clinicians' recordings, respectively (p = 0.007). Image quality was highest in the clinicians' recordings. Mean difference ± standard deviation of the automatic measurements of the students' recordings compared to the manual reference was − 0.0 ± 2.0 mm for MAPSE, 0.3 ± 1.1 cm/s for S′ and 0.6 ± 1.4 cm/s for e′. The corresponding intraclass correlation coefficients for MAPSE, S′ and e′ were 0.85 (good), 0.89 (good) and 0.92 (excellent), respectively. Automatic measurements from the students' and clinicians' recordings were in similar agreement with the reference when mitral annular tracking was correct.(Continued on next page) Conclusions: In case of correct tracking of the mitral annulus, the agreement with reference for the automatic measurements was overall good. Low image quality reduced feasibility. Adequate image acquisition is essential for automatic analyses of LV function indices, and thus, appropriate education of the operators is mandatory. Automatic measurements may help inexperienced users of ultrasound, but do not remove the need for dedicated education and training.

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“…Most handheld devices -either a pocketsize probe or an ultrasound probe that can be plugged directly into a personal mobile device-support only B-mode and color Doppler. They have shown good diagnostic value compared to standard echocardiography in the basic assessment of gross alterations of cardiac morphology and function [9]. Nevertheless, portable devices may offer a greater and superior resolution of the screen in addition to the possibility to use multiple imaging modalities, i. e. M-mode, B-mode, pulsed wave Doppler (PW), continuous wave Doppler (CW).…”

Section: Us Devices and 'How To' Basicsmentioning

confidence: 99%

“…Die meisten tragbaren Geräteentweder im Taschenformat oder Ultraschallsonden, die direkt an ein persönliches Mobilgerät angeschlossen werden könnenunterstützen nur den B-Modus und den Farbdoppler. Sie haben im Vergleich zur Standard-Echokardiografie einen guten diagnostischen Wert bei der grundlegenden Beurteilung von groben Veränderungen der Herzmorphologie und -funktion gezeigt [9]. Dennoch bieten tragbare Geräte neben der Möglichkeit, mehrere Bildgebungsmodalitäten zu nutzen, d. h. M-Modus, B-Modus, Pulsed-wave-Doppler (PW), Continuous-Wave-Doppler (CW), eine größere und bessere Auflösung des Bildschirms.…”

Section: Us-geräte Und Anleitungenunclassified

I Will Be at Your (Bed)Side – The Role of Bedside Echocardiography for Non-Cardiologists

et al. 2020

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As the availability of portable echocardiographic equipment is becoming more and more widespread, physicians can add a powerful tool to their bedside examination skills, thus helping them to more effectively face the growing complexity of patients admitted to internal medicine departments or the emergency room. Focused cardiac ultrasound (FoCUS) can be defined as a goal-directed, simplified, qualitative examination performed at the bedside using portable echocardiographic devices. FoCUS is not meant to be a substitute for a standard 2D color Doppler echocardiographic examination. Nevertheless, it can provide rapid and reliable information when limited to basic questions, even when performed by non-cardiologists with brief training. Furthermore, a focused cardiac ultrasound examination maximizes its diagnostic role when integrated with an ultrasonographic assessment of the lung, abdomen and deep veins, in a multisystem approach that is particularly dear to internists. In this article, we will focus on the specific targets of a focused cardiac ultrasound examination, as well as the most common pitfalls that can be encountered in ultrasonographic practice. We will also address the application of FoCUS in the management of two typical scenarios in clinical practice, such as dyspnea and non-post-traumatic hypotension.

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The use of handheld ultrasound devices: a position statement of the European Association of Cardiovascular Imaging (2018 update)

Cited by 105 publications

References 79 publications

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Imaging in patients with suspected acute heart failure: timeline approach position statement on behalf of the Heart Failure Association of the European Society of Cardiology

Automatic quantification of left ventricular function by medical students using ultrasound

I Will Be at Your (Bed)Side – The Role of Bedside Echocardiography for Non-Cardiologists

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