Synapse
⌘+K
Synapse
PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
April 5, 2022BMC AnesthesiologyOpen Access

Pre-operative point-of-care assessment of left ventricular diastolic dysfunction, an observational study

View Full Paper
Ask AI
Bookmark
Share

Why the study?

LV diastolic dysfunction is an acknowledged peri-operative risk factor that should be identified before surgery, motivating the evaluation of a simplified echocardiographic method using e' and E/e' for pre-operative identification and grading.

Does a simplified echocardiographic method using e' and E/e' accurately identify left ventricular diastolic dysfunction in pre-operative ambulatory surgical patients compared to comprehensive assessment?

Population

96 consecutive ambulatory surgical patients

Comparison

Simplified echocardiographic assessment using e' and E/e' vs comprehensive assessment

Design

Prospective observational study

Authors

YSYlva StenbergYRYlva RhodinALAnne Lindberg

Discussion

Loading...

Member takes

Overview

A simplified point-of-care echocardiographic approach using tissue Doppler e'-velocities can effectively rule out pre-operative left ventricular diastolic dysfunction, though it may overestimate its severity when combined with the E/e' ratio.

Structured PICO

Does a simplified echocardiographic method using e' and E/e' accurately identify left ventricular diastolic dysfunction in pre-operative ambulatory surgical patients compared to comprehensive assessment?

P
Population
96 ambulatory surgical patients, mean age 63, 88% female, in Sweden. Key exclusions: severe calcification of the mitral annulus, significant mitral valve regurgitation, arrhythmias (atrial fibrillation/flutter, multiple extrasystoles), and poor acquisition quality.
I
Intervention
Simplified echocardiographic method using tissue Doppler e'-velocities and E/e' ratio for identification and grading of left ventricular diastolic dysfunction pre-operatively.
C
Comparator
Comprehensive echocardiographic assessment according to 2009 American Society of Echocardiography (ASE) guidelines.
O
Outcome
Accuracy of e'-velocities to discriminate patients with diastolic dysfunction (measured by AUROC, PPV, NPV, sensitivity, specificity, and test efficiency).surrogate

A simplified point-of-care echocardiographic approach using tissue Doppler e'-velocities can effectively rule out pre-operative left ventricular diastolic dysfunction, though it may overestimate its severity when combined with the E/e' ratio.

Limitations

  • Accuracy of evaluated tests may decrease with a less experienced observer.
  • The 2016 ASE guidelines were not used, which might have classified some patients as indeterminate.
  • Study sample size was too small to evaluate the significance of hs-TnI for cardiac risk assessment.
  • No intra- and postoperative data were analyzed, so association with outcomes was not assessed.
  • Poor PPV and low specificity may allow for misdiagnosis, and the simplified method exaggerates severity.

Cite This Study

Stenberg et al. (2022) studied this question.

synapsesocial.com/papers/6a8338abab7e78751db37a15https://doi.org/10.1186/s12871-022-01642-4
View Full Paper
Ask AI
Bookmark
Share