Diagnostic performance of a clinical ultrasound-based algorithm for acute heart failure in patients presenting to the emergency department with dyspnea
OBJECTIVES: To study the diagnostic performance of an ultrasound-based algorithm that includes the deceleration time (DT) of early mitral filling to establish a diagnosis of acute heart failure (AHF) in patients who come to an emergency department because of dyspnea.
MATERIAL AND METHODS: Prospective analysis in a convenience sample of patients who came to a hospital emergency department with acute dyspnea. The algorithm included ultrasound findings and 4 echocardiographic findings as follows: mitral annular plane systolic excursion, Doppler mitral flow velocity, tissue Doppler imaging measure of the lateral annulus, and the DT of early mitral filling. The definitive diagnosis was made by 2 physicians blinded to each other's diagnosis and the ultrasound findings.
RESULTS: A total of 166 adult patients with a mean (SD) age of 76 (13) years were included; 79 (48%) were women. AHF was the definitive diagnosis in 62 patients (37%). Diagnostic agreement was good between the 2 physicians (κ = 0.71). The algorithm classified all the patients, and there were no undetermined diagnoses. Diagnostic performance indicators for the ultrasound-based algorithm integrating early DT findings were as follows: area under the receiver operating characteristic curve, 0.91 (95% CI, 0.86-0.96); sensitivity, 87% (95% CI, 76%-94%); specificity, 95% (95% CI, 89%-98%); positive likelihood ratio, 18.1 (95% CI, 7.7-42.8); and negative likelihood ratio, 0.14 (95% CI, 0.07-0.26).
CONCLUSION: The ultrasound-based algorithm integrating the DT of early mitral filling performs well for diagnosing AHF in emergency patients with dyspnea. The inclusion of early DT allows all patients to be diagnosed.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias - 36(2024), 2 vom: 16. Apr., Seite 109-115 |
| Sprache: |
Spanisch |
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| Weiterer Titel: |
Rendimiento diagnóstico de un algoritmo basado en ecografía clínica para el diagnóstico de insuficiencia cardiaca aguda en pacientes que consultan en urgencias por disnea |
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| Beteiligte Personen: |
L'Hermitte, Nicolas [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 15.04.2024 Date Revised 15.04.2024 published: Print Citation Status MEDLINE |
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| doi: |
10.55633/s3me/011.2024 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM370966147 |
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| 100 | 1 | |a L'Hermitte, Nicolas |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diagnostic performance of a clinical ultrasound-based algorithm for acute heart failure in patients presenting to the emergency department with dyspnea |
| 246 | 3 | 3 | |a Rendimiento diagnóstico de un algoritmo basado en ecografía clínica para el diagnóstico de insuficiencia cardiaca aguda en pacientes que consultan en urgencias por disnea |
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| 500 | |a Date Completed 15.04.2024 | ||
| 500 | |a Date Revised 15.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To study the diagnostic performance of an ultrasound-based algorithm that includes the deceleration time (DT) of early mitral filling to establish a diagnosis of acute heart failure (AHF) in patients who come to an emergency department because of dyspnea | ||
| 520 | |a MATERIAL AND METHODS: Prospective analysis in a convenience sample of patients who came to a hospital emergency department with acute dyspnea. The algorithm included ultrasound findings and 4 echocardiographic findings as follows: mitral annular plane systolic excursion, Doppler mitral flow velocity, tissue Doppler imaging measure of the lateral annulus, and the DT of early mitral filling. The definitive diagnosis was made by 2 physicians blinded to each other's diagnosis and the ultrasound findings | ||
| 520 | |a RESULTS: A total of 166 adult patients with a mean (SD) age of 76 (13) years were included; 79 (48%) were women. AHF was the definitive diagnosis in 62 patients (37%). Diagnostic agreement was good between the 2 physicians (κ = 0.71). The algorithm classified all the patients, and there were no undetermined diagnoses. Diagnostic performance indicators for the ultrasound-based algorithm integrating early DT findings were as follows: area under the receiver operating characteristic curve, 0.91 (95% CI, 0.86-0.96); sensitivity, 87% (95% CI, 76%-94%); specificity, 95% (95% CI, 89%-98%); positive likelihood ratio, 18.1 (95% CI, 7.7-42.8); and negative likelihood ratio, 0.14 (95% CI, 0.07-0.26) | ||
| 520 | |a CONCLUSION: The ultrasound-based algorithm integrating the DT of early mitral filling performs well for diagnosing AHF in emergency patients with dyspnea. The inclusion of early DT allows all patients to be diagnosed | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute heart failure. | |
| 650 | 4 | |a Deceleration time of early mitral flow. | |
| 650 | 4 | |a Desaceleración precoz del flujo mitral | |
| 650 | 4 | |a Echocardiography | |
| 650 | 4 | |a Ecocardiografía. | |
| 650 | 4 | |a Ecografía pulmonar. | |
| 650 | 4 | |a Emergency department. | |
| 650 | 4 | |a Insuficiencia cardiaca aguda. | |
| 650 | 4 | |a Servicio de emergencias. | |
| 650 | 4 | |a Ultrasonography, lung. | |
| 700 | 1 | |a Markarian, Thibaut |e verfasserin |4 aut | |
| 700 | 1 | |a Grau-Mercier, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Coisy, Fabien |e verfasserin |4 aut | |
| 700 | 1 | |a Muller, Laurent |e verfasserin |4 aut | |
| 700 | 1 | |a Saadi, Laysa |e verfasserin |4 aut | |
| 700 | 1 | |a Claret, Pierre-Géraud |e verfasserin |4 aut | |
| 700 | 1 | |a Krebs, Hugo |e verfasserin |4 aut | |
| 700 | 1 | |a Bobbia, Xavier |e verfasserin |4 aut | |
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