High accuracy of bedside FoCUS EF evaluations supports heart failure diagnosis

The measurements of ejection fraction (EF) by the operational method were shown to be more precise than those obtained by the unselected images of the software application.

"The correlations between the bedside FoCUS EF measurements versus standard echocardiography were statistically significant (r= +0.694 and r=+ 0.571)," the researchers reported. "The EF measurements by the operational method are precise."

Point-of-care ultrasound is being increasingly used in medical practice. Antonio Martocchia from Sapienza University of Romei n Rome, Italy, and colleagues aimed to evaluate the left ventricle systolic function by the bedside FoCUS.

For this purpose, the researchers 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. A comparison was made between the LV EF measurements and those obtained by standard echocardiography (as gold standard).

The researchers reported the following findings:

• 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%).

"Our findings showed a high accuracy of the bedside FoCUS EF evaluations, which may support the diagnosis of heart failure in an emergency setting without delaying," the investigators wrote.

"The measurements of ejection fraction by the operational method are more precise than those obtained by the unselected images of the software application," they concluded.

Reference:

Martocchia, A., Piccoli, C., Notarangelo, M.F. et al. The measurement of the left ventricle ejection fraction by a bedside FoCUS examination. Intern Emerg Med (2023). https://doi.org/10.1007/s11739-023-03414-5