Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care
INTRODUCTION: Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by usi...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387642/ https://www.ncbi.nlm.nih.gov/pubmed/21846331 http://dx.doi.org/10.1186/cc10368 |
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author | Bergenzaun, Lill Gudmundsson, Petri Öhlin, Hans Düring, Joachim Ersson, Anders Ihrman, Lilian Willenheimer, Ronnie Chew, Michelle S |
author_facet | Bergenzaun, Lill Gudmundsson, Petri Öhlin, Hans Düring, Joachim Ersson, Anders Ihrman, Lilian Willenheimer, Ronnie Chew, Michelle S |
author_sort | Bergenzaun, Lill |
collection | PubMed |
description | INTRODUCTION: Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE). METHODS: Fifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI). RESULTS: EBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ranging from 0.79 to 0.95 (P < 0.01). the Simpson correlations with the other LV parameters showed substantial variation over time, with the poorest results seen for TDIs and AVPDm. The repeatability was best for VTI (interobserver coefficient of variation (CV) 4.8%, and intraobserver CV, 3.1%), and AVPDm (5.3% and 4.4%, respectively), and worst for the Simpson method (8.2% and 10.6%, respectively). CONCLUSIONS: EBEF and AVPDm provided the best, and Simpson, the worst feasibility when assessing LV systolic function in a population of mechanically ventilated, hemodynamically unstable patients. Additionally, the Simpson showed the poorest repeatability. We suggest that EBEF can be used instead of single-plane Simpson when assessing LV ejection fraction in this category of patients. TDIs and AVPDm, as markers of longitudinal function of the LV, are not interchangeable with LV ejection fraction. |
format | Online Article Text |
id | pubmed-3387642 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-33876422012-07-02 Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care Bergenzaun, Lill Gudmundsson, Petri Öhlin, Hans Düring, Joachim Ersson, Anders Ihrman, Lilian Willenheimer, Ronnie Chew, Michelle S Crit Care Research INTRODUCTION: Assessing left ventricular (LV) systolic function in a rapid and reliable way can be challenging in the critically ill patient. The purpose of this study was to evaluate the feasibility and reliability of, as well as the association between, commonly used LV systolic parameters, by using serial transthoracic echocardiography (TTE). METHODS: Fifty patients with shock and mechanical ventilation were included. TTE examinations were performed daily for a total of 7 days. Methods used to assess LV systolic function were visually estimated, "eyeball" ejection fraction (EBEF), the Simpson single-plane method, mean atrioventricular plane displacement (AVPDm), septal tissue velocity imaging (TDIs), and velocity time integral in the left ventricular outflow tract (VTI). RESULTS: EBEF, AVPDm, TDIs, VTI, and the Simpson were obtained in 100%, 100%, 99%, 95% and 93%, respectively, of all possible examinations. The correlations between the Simpson and EBEF showed r values for all 7 days ranging from 0.79 to 0.95 (P < 0.01). the Simpson correlations with the other LV parameters showed substantial variation over time, with the poorest results seen for TDIs and AVPDm. The repeatability was best for VTI (interobserver coefficient of variation (CV) 4.8%, and intraobserver CV, 3.1%), and AVPDm (5.3% and 4.4%, respectively), and worst for the Simpson method (8.2% and 10.6%, respectively). CONCLUSIONS: EBEF and AVPDm provided the best, and Simpson, the worst feasibility when assessing LV systolic function in a population of mechanically ventilated, hemodynamically unstable patients. Additionally, the Simpson showed the poorest repeatability. We suggest that EBEF can be used instead of single-plane Simpson when assessing LV ejection fraction in this category of patients. TDIs and AVPDm, as markers of longitudinal function of the LV, are not interchangeable with LV ejection fraction. BioMed Central 2011 2011-08-16 /pmc/articles/PMC3387642/ /pubmed/21846331 http://dx.doi.org/10.1186/cc10368 Text en Copyright ©2011 Bergenzaun et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Bergenzaun, Lill Gudmundsson, Petri Öhlin, Hans Düring, Joachim Ersson, Anders Ihrman, Lilian Willenheimer, Ronnie Chew, Michelle S Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title | Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title_full | Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title_fullStr | Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title_full_unstemmed | Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title_short | Assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
title_sort | assessing left ventricular systolic function in shock: evaluation of echocardiographic parameters in intensive care |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3387642/ https://www.ncbi.nlm.nih.gov/pubmed/21846331 http://dx.doi.org/10.1186/cc10368 |
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