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. 2012 Oct;29(5):534-40.
doi: 10.1093/fampra/cms009. Epub 2012 Feb 14.

Assessment of left ventricular function by GPs using pocket-sized ultrasound

Ole Christian Mjølstad  1 , Sten Roar Snare, Lasse Folkvord, Frode Helland, Anders Grimsmo, Hans Torp, Olav Haraldseth, Bjørn Olav Haugen
Affiliations

Assessment of left ventricular function by GPs using pocket-sized ultrasound

Ole Christian Mjølstad et al. Fam Pract. 2012 Oct.

Abstract

Background: Assessment of left ventricular (LV) function with echocardiography is mandatory in patients with suspected heart failure (HF).

Objectives: To investigate if GPs were able to evaluate the LV function in patients at risk of developing or with established HF by using pocket-sized ultrasound (pUS).

Methods: Feasibility study in general practice, seven GPs in three different Norwegian primary care centres participated. Ninety-two patients with reduced or at risk of developing reduced LV function were examined by their own GP using pUS. The scan (<5 minute) was done as part of a routine appointment. A cardiologist examined the patients <30 minutes afterwards with both a laptop scanner and pUS. Measurements of the septal mitral annular excursion (sMAE) were compared.

Results: In 87% of the patients, the GPs were able to obtain a standard view and measure the sMAE. There was a non-significant mean difference in sMAE between GP pUS and cardiologist laptop scanner of -0.15 mm 95% confidence interval (-0.60 to 0.30) mm. A comparison of the pUS recordings and measurements of sMAE made by GP versus cardiologist revealed a non-significant mean difference with acceptable 95% limits of agreement (-0.26 ± 3.02 mm).

Conclusions: With tailored training, GPs were able to assess LV function with sMAE and pUS. pUS, as a supplement to the physical examination, may become an important tool in general practice.

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Figures

F<sc>igure</sc> 1
Figure 1
Two-dimensional recording of the left ventricle in end diastole (left) and end systole (right). The red line indicates the position of the mitral annular septum in end diastole and the green line, the position in end systole. The distance between the lines (red arrows) represents the total distance/excursion by the septal part of the mitral annulus through a complete heart cycle
F<sc>igure</sc> 2
Figure 2
M-mode registration of sMAE. The distance between the red lines (arrow) indicates the total distance/excursion by the septal part of the mitral annulus through a complete heart cycle
F<sc>igure</sc> 3
Figure 3
Ninety-five per cent limits of agreement between measurements of sMAE with pUS (Vscan) performed and analysed by the GPs versus the cardiologist
F<sc>igure</sc> 4
Figure 4
Ninety-five per cent limits of agreement between measurements of sMAE with pUS (Vscan) performed by the GPs and analysed by the second cardiologist versus the cardiologist
See this image and copyright information in PMC

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