Preoperative Point-of-Care Assessment of Left Ventricular Systolic Dysfunction With Transthoracic Echocardiography
| Autor: | Magnus Hultin, Anne Lindberg, Tomi Myrberg, Ylva Stenberg, Lina Wallinder, Jakob Walldén |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Ejection fraction business.industry Stroke volume Perioperative Preoperative care Doppler imaging 03 medical and health sciences 0302 clinical medicine Anesthesiology and Pain Medicine 030202 anesthesiology Internal medicine Predictive value of tests medicine Cardiology Systole Prospective cohort study business 030217 neurology & neurosurgery |
| Zdroj: | Anesthesia & Analgesia. 132:717-725 |
| ISSN: | 0003-2999 |
| Popis: | BACKGROUND Left ventricular (LV) systolic dysfunction is an acknowledged perioperative risk factor and should be identified before surgery. Conventional echocardiographic assessment of LV ejection fraction (LVEF) obtained by biplane LV volumes is the gold standard to detect LV systolic dysfunction. However, this modality needs extensive training and is time consuming. Hence, a feasible point-of-care screening method for this purpose is warranted. The aim of this study was to evaluate 3 point-of-care echocardiographic methods for identification of LV systolic dysfunction in comparison with biplane LVEF. METHODS One hundred elective surgical patients, with a mean age of 63 ± 12 years and body mass index of 27 ± 4 kg/m2, were consecutively enrolled in this prospective observational study. Transthoracic echocardiography was conducted 1-2 hours before surgery. LVEF was obtained by automatic two-dimensional (2D) biplane ejection fraction (EF) software. We evaluated if 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) could discriminate LV systolic dysfunction (LVEF 6 mm had an AUROC 0.89 (95% CI, 0.80-0.98; P < .001), with a PPV of 67% and an NPV of 96%. MAPSE (mean |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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