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床旁 Focus 检查测量左心室射血分数。

The measurement of the left ventricle ejection fraction by a bedside FoCUS examination.

机构信息

Emergency Medicine Unit, S. Andrea Hospital, Sapienza University of Rome, Via di Grottarossa 1035, 00189, Rome, Italy.

Radiology Unit, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.

出版信息

Intern Emerg Med. 2023 Nov;18(8):2253-2259. doi: 10.1007/s11739-023-03414-5. Epub 2023 Sep 10.

Abstract

The use of point-of-care ultrasound is rapidly increasing in medical practice. This study aims to evaluate the left ventricle systolic function by the bedside focus cardiac ultrasound (FoCUS). We consecutively enrolled n.59 patients of the Emergency Medicine Unit of S. Andrea Hospital. Every patient received a bedside FoCUS examination to estimate the left ventricle (LV) ejection fraction (EF); the LV EF measurements were compared with those obtained by standard echocardiography (as gold standard). The LV EF obtained by the bedside FoCUS examination and the standard echocardiography, resulted, respectively: 50.2 ± 15.1% (by the Quinones equation), 39.5 + 12.0% (by the Lvivo app) and 53.7 + 11.1% (by the standard echocardiography). The correlations between the bedside FoCUS EF measurements versus standard echocardiography were statistically significant: r =  + 0.694 p < 1.9 × 10 (Quinones equation, Bland-Altman analysis mean = - 2.3%) and r =  + 0.571 p < 0.01 (Lvivo app, Bland-Altman analysis mean = - 13.3%). In conclusion, the present study showed a high accuracy of the bedside FoCUS EF evaluations, which may support the diagnosis of the heart failure in an emergency setting without delaying. The EF measurements by the operational method are more precise than those obtained by the unselected images of the software application.

摘要

床边即时心脏超声(FoCUS)在医学实践中的应用正在迅速增加。本研究旨在通过床边 FoCUS 评估左心室收缩功能。我们连续纳入了 S. Andrea 医院急诊医学科的 59 名患者。每位患者均接受床边 FoCUS 检查以评估左心室(LV)射血分数(EF);将 LV EF 测量值与标准超声心动图(作为金标准)获得的值进行比较。床边 FoCUS 检查和标准超声心动图获得的 LV EF 分别为:50.2±15.1%(通过 Quinones 方程)、39.5±12.0%(通过 Lvivo 应用)和 53.7±11.1%(通过标准超声心动图)。床边 FoCUS EF 测量值与标准超声心动图之间的相关性具有统计学意义:r=+0.694,p<0.01(Quinones 方程,Bland-Altman 分析均值=-2.3%)和 r=+0.571,p<0.01(Lvivo 应用,Bland-Altman 分析均值=-13.3%)。总之,本研究表明床边 FoCUS EF 评估具有很高的准确性,这可能有助于在不延误的情况下在急诊环境中诊断心力衰竭。操作方法获得的 EF 测量值比软件应用程序的未选图像获得的 EF 测量值更精确。

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