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November 3, 2020Anesthesia & Analgesia

Preoperative Point-of-Care Assessment of Left Ventricular Systolic Dysfunction With Transthoracic Echocardiography

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Why the study?

Preoperative identification of LV systolic dysfunction is important, but conventional biplane LVEF requires extensive training and is time-consuming, warranting a feasible point-of-care screening method.

Do point-of-care echocardiographic methods (TDISm, EPSS, MAPSE) accurately identify left ventricular systolic dysfunction compared to biplane LVEF in elective surgical patients?

Comparison

TDISm, EPSS, and MAPSE vs biplane LVEF

Design

Prospective observational study

Authors

YSYlva StenbergLWLina WallinderALAnne Lindberg

Discussion

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Overview

EPSS and MAPSE may aid point-of-care detection of reduced LVEF in elective surgery; hypothesis-generating and requires prospective validation.

Structured PICO

Do point-of-care echocardiographic methods (TDISm, EPSS, MAPSE) accurately identify left ventricular systolic dysfunction compared to biplane LVEF in elective surgical patients?

P
Population
100 elective surgical patients, mean age 63 ± 12 years, BMI 27 ± 4 kg/m2.
I
Intervention
Point-of-care echocardiographic methods (Tissue Doppler Imaging peak systolic myocardial velocities [TDISm], anatomic M-mode E-point septal separation [EPSS], and conventional M-mode mitral annular plane systolic excursion [MAPSE])
C
Comparator
Conventional echocardiographic assessment of LV ejection fraction (LVEF) obtained by automatic two-dimensional (2D) biplane ejection fraction software
O
Outcome
Discrimination of LV systolic dysfunction (LVEF <50%) measured by area under the receiver operating characteristic curve (AUROC), positive predictive value (PPV), and negative predictive value (NPV)surrogate

Cite This Study

Stenberg et al. (2020) studied this question.

synapsesocial.com/papers/6a1bf4cc01af05bf0da9048dhttps://doi.org/10.1213/ane.0000000000005263
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pre-Operative Point-of-Care Assessment of Left Ventricular Diastolic Dysfunction, an Observational Study2022
  2. 2Pre-operative point-of-care assessment of left ventricular diastolic dysfunction, an observational study2022 · 4 citations
  3. 3E-Point Septal Separation Accuracy for the Diagnosis of Mild and Severe Reduced Ejection Fraction in Emergency Department Patients2022 · 6 citations
  4. 4Assessment of Left Ventricular Size and Function during Cardiac Surgery. An Intraoperative Evaluation of Six Two‐Dimensional Echocardiographic Methods with Real Time Three‐Dimensional Echocardiography as a Reference2013 · 18 citations
  5. 5Diagnostic accuracy and clinical utility of echocardiographic indices for detecting left ventricular diastolic dysfunction in patients with coronary artery disease and normal ejection fraction2011 · 7 citations