MI Laboratory, Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, 7491 Trondheim, Norway.
Fam Pract. 2012 Oct;29(5):534-40. doi: 10.1093/fampra/cms009. Epub 2012 Feb 14.
Assessment of left ventricular (LV) function with echocardiography is mandatory in patients with suspected heart failure (HF).
To investigate if GPs were able to evaluate the LV function in patients at risk of developing or with established HF by using pocket-sized ultrasound (pUS).
Feasibility study in general practice, seven GPs in three different Norwegian primary care centres participated. Ninety-two patients with reduced or at risk of developing reduced LV function were examined by their own GP using pUS. The scan (<5 minute) was done as part of a routine appointment. A cardiologist examined the patients <30 minutes afterwards with both a laptop scanner and pUS. Measurements of the septal mitral annular excursion (sMAE) were compared.
In 87% of the patients, the GPs were able to obtain a standard view and measure the sMAE. There was a non-significant mean difference in sMAE between GP pUS and cardiologist laptop scanner of -0.15 mm 95% confidence interval (-0.60 to 0.30) mm. A comparison of the pUS recordings and measurements of sMAE made by GP versus cardiologist revealed a non-significant mean difference with acceptable 95% limits of agreement (-0.26 ± 3.02 mm).
With tailored training, GPs were able to assess LV function with sMAE and pUS. pUS, as a supplement to the physical examination, may become an important tool in general practice.
在疑似心力衰竭（HF）患者中，使用超声心动图评估左心室（LV）功能是强制性的。
研究全科医生（GP）是否能够通过使用掌上超声（pUS）评估有发生或已经发生 HF 风险的患者的 LV 功能。
在全科医学中的可行性研究，来自三个不同的挪威初级保健中心的 7 名全科医生参与了该研究。92 名 LV 功能降低或有降低风险的患者由其自身 GP 使用 pUS 进行检查。扫描（<5 分钟）作为常规预约的一部分进行。<30 分钟后，心脏病专家使用笔记本电脑扫描仪和 pUS 对患者进行检查。比较了间隔二尖瓣环运动（sMAE）的测量结果。
在 87%的患者中，GP 能够获得标准视图并测量 sMAE。GP 的 pUS 和心脏病专家的笔记本电脑扫描仪之间的 sMAE 平均差异无统计学意义（-0.15mm，95%置信区间（CI）为-0.60 至 0.30）mm。GP 与心脏病专家对 pUS 记录和 sMAE 测量值的比较显示，平均差异无统计学意义，具有可接受的 95%一致性界限（-0.26±3.02mm）。
经过专门培训，GP 能够使用 sMAE 和 pUS 评估 LV 功能。pUS 作为体格检查的补充，可能成为全科医学中的重要工具。
