Guppy-Coles Kristyan B, Prasad Sandhir B, Smith Kym C, Hillier Samuel, Lo Ada, Atherton John J
Department of Cardiology, Royal Brisbane and Women's Hospital, Brisbane, Qld, Australia.
University of Queensland School of Medicine, Brisbane, Qld, Australia.
J Clin Nurs. 2015 Jun;24(11-12):1479-88. doi: 10.1111/jocn.12666. Epub 2014 Sep 25.
We aimed to determine the feasibility of training cardiac nurses to evaluate left ventricular function utilising a semi-automated, workstation-based protocol on three dimensional echocardiography images.
Assessment of left ventricular function by nurses is an attractive concept. Recent developments in three dimensional echocardiography coupled with border detection assistance have reduced inter- and intra-observer variability and analysis time. This could allow abbreviated training of nurses to assess cardiac function.
A comparative, diagnostic accuracy study evaluating left ventricular ejection fraction assessment utilising a semi-automated, workstation-based protocol performed by echocardiography-naïve nurses on previously acquired three dimensional echocardiography images.
Nine cardiac nurses underwent two brief lectures about cardiac anatomy, physiology and three dimensional left ventricular ejection fraction assessment, before a hands-on demonstration in 20 cases. We then selected 50 cases from our three dimensional echocardiography library based on optimal image quality with a broad range of left ventricular ejection fractions, which was quantified by two experienced sonographers and the average used as the comparator for the nurses. Nurses independently measured three dimensional left ventricular ejection fraction using the Auto lvq package with semi-automated border detection.
The left ventricular ejection fraction range was 25-72% (70% with a left ventricular ejection fraction <55%). All nurses showed excellent agreement with the sonographers. Minimal intra-observer variability was noted on both short-term (same day) and long-term (>2 weeks later) retest.
It is feasible to train nurses to measure left ventricular ejection fraction utilising a semi-automated, workstation-based protocol on previously acquired three dimensional echocardiography images. Further study is needed to determine the feasibility of training nurses to acquire three dimensional echocardiography images on real-world patients to measure left ventricular ejection fraction.
Nurse-performed evaluation of left ventricular function could facilitate the broader application of echocardiography to allow cost-effective screening and monitoring for left ventricular dysfunction in high-risk populations.
我们旨在确定培训心脏科护士使用基于工作站的半自动方案，利用三维超声心动图图像评估左心室功能的可行性。
护士对左心室功能进行评估是一个有吸引力的概念。三维超声心动图的最新进展以及边界检测辅助技术减少了观察者间和观察者内的变异性以及分析时间。这可以使护士接受简短培训以评估心脏功能。
一项比较性诊断准确性研究，评估使用基于工作站的半自动方案，由未接触过超声心动图的护士对先前获取的三维超声心动图图像进行左心室射血分数评估。
九名心脏科护士在接受关于心脏解剖学、生理学和三维左心室射血分数评估的两次简短讲座后，对20例患者进行了实际操作演示。然后，我们从三维超声心动图库中选择了50例图像质量最佳、左心室射血分数范围广泛的病例，由两名经验丰富的超声检查人员对其进行量化，并将平均值用作护士评估的比较标准。护士使用具有半自动边界检测功能的Auto lvq软件包独立测量三维左心室射血分数。
左心室射血分数范围为25% - 72%（70%的左心室射血分数<55%）。所有护士与超声检查人员的评估结果高度一致。在短期（同一天）和长期（>2周后）重新测试中，观察者内变异性极小。
培训护士使用基于工作站的半自动方案，利用先前获取的三维超声心动图图像测量左心室射血分数是可行的。需要进一步研究以确定培训护士在实际患者中获取三维超声心动图图像以测量左心室射血分数的可行性。
护士进行的左心室功能评估有助于更广泛地应用超声心动图，以便在高危人群中进行具有成本效益的左心室功能障碍筛查和监测。
