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Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors

BACKGROUND: Dyspnea is a high priority symptom in the emergency department, with heart failure (HF) as one of its leading causes. Recently, the “comet tail sign (CTS),” a pulmonary ultrasonographic sign, has been proposed as an efficacious tool for detecting pulmonary edema. However, to the best of...

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Autores principales: Nagaharu, Keiki, Tsumura, Natsumi, Itoh, Toshiyuki, Murata, Tetsuya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634130/
https://www.ncbi.nlm.nih.gov/pubmed/36349208
http://dx.doi.org/10.1002/jgf2.575
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author Nagaharu, Keiki
Tsumura, Natsumi
Itoh, Toshiyuki
Murata, Tetsuya
author_facet Nagaharu, Keiki
Tsumura, Natsumi
Itoh, Toshiyuki
Murata, Tetsuya
author_sort Nagaharu, Keiki
collection PubMed
description BACKGROUND: Dyspnea is a high priority symptom in the emergency department, with heart failure (HF) as one of its leading causes. Recently, the “comet tail sign (CTS),” a pulmonary ultrasonographic sign, has been proposed as an efficacious tool for detecting pulmonary edema. However, to the best of our knowledge, there have been no published data regarding its utility when performed by non‐experts, including junior residents. METHODS: Between September 2017 and December 2018, patients with dyspnea, who were admitted to the ER, were enrolled. CTS was evaluated by junior residents at the ER. All patients were evaluated by cardiologists independently, and clinical HF was defined as requiring pharmacological intervention by a cardiologist. At the end of this study, we investigated the results of CTS, laboratory data, and available radiological images. RESULTS: A total of 95 patients were enrolled in the current study, wherein 42 patients were treated by cardiologists as those with clinical HF. Our results showed that CTS could identify clinical HF with a sensitivity of 71.4% and a specificity of 81.1%. The sensitivity of CTS against brain natriuretic peptide (BNP) (cut‐off value, 100 pg/ml) was calculated at 92.5%. Furthermore, when evaluated together with peripheral edema, CTS identified clinical HF with a sensitivity of 96%. False positives for CTS included bilateral pneumonia, hypoalbuminemia, and interstitial pneumonitis. CONCLUSIONS: Our results indicate that CTS is a simple and effective tool for the use of non‐experts, including junior residents.
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spelling pubmed-96341302022-11-07 Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors Nagaharu, Keiki Tsumura, Natsumi Itoh, Toshiyuki Murata, Tetsuya J Gen Fam Med Original Articles BACKGROUND: Dyspnea is a high priority symptom in the emergency department, with heart failure (HF) as one of its leading causes. Recently, the “comet tail sign (CTS),” a pulmonary ultrasonographic sign, has been proposed as an efficacious tool for detecting pulmonary edema. However, to the best of our knowledge, there have been no published data regarding its utility when performed by non‐experts, including junior residents. METHODS: Between September 2017 and December 2018, patients with dyspnea, who were admitted to the ER, were enrolled. CTS was evaluated by junior residents at the ER. All patients were evaluated by cardiologists independently, and clinical HF was defined as requiring pharmacological intervention by a cardiologist. At the end of this study, we investigated the results of CTS, laboratory data, and available radiological images. RESULTS: A total of 95 patients were enrolled in the current study, wherein 42 patients were treated by cardiologists as those with clinical HF. Our results showed that CTS could identify clinical HF with a sensitivity of 71.4% and a specificity of 81.1%. The sensitivity of CTS against brain natriuretic peptide (BNP) (cut‐off value, 100 pg/ml) was calculated at 92.5%. Furthermore, when evaluated together with peripheral edema, CTS identified clinical HF with a sensitivity of 96%. False positives for CTS included bilateral pneumonia, hypoalbuminemia, and interstitial pneumonitis. CONCLUSIONS: Our results indicate that CTS is a simple and effective tool for the use of non‐experts, including junior residents. John Wiley and Sons Inc. 2022-08-17 /pmc/articles/PMC9634130/ /pubmed/36349208 http://dx.doi.org/10.1002/jgf2.575 Text en © 2022 The Authors. Journal of General and Family Medicine published by John Wiley & Sons Australia, Ltd on behalf of Japan Primary Care Association. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Nagaharu, Keiki
Tsumura, Natsumi
Itoh, Toshiyuki
Murata, Tetsuya
Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title_full Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title_fullStr Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title_full_unstemmed Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title_short Diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
title_sort diagnostic utility of lung echography for congestive heart failure performed by junior resident doctors
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9634130/
https://www.ncbi.nlm.nih.gov/pubmed/36349208
http://dx.doi.org/10.1002/jgf2.575
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