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

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 × 10-6 (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.

Keywords: Bedside ultrasound; Echocardiography; Ejection fraction; Heart failure.

MeSH terms

  • Emergency Medicine*
  • Heart Ventricles
  • Humans
  • Quinones
  • Reproducibility of Results
  • Stroke Volume
  • Ventricular Dysfunction, Left*
  • Ventricular Function, Left

Substances

  • Quinones