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- Title
Rendimiento de un algoritmo basado en ecografía cardiopulmonar a la cabecera del paciente (POCUS) para el diagnóstico de insuficiencia cardiaca aguda en pacientes que consultan en urgencias por disnea aguda.
- Authors
Vauthier, Candice; Chabannon, Margaux; Markarian, Thibaut; Taillandy, Yann; Guillemet, Kevin; Krebs, Hugo; Bazalgette, Florian; Muller, Laurent; Claret, Pierre-Géraud; Bobbia, Xavier
- Abstract
Background and objective. Cardiopulmonary ultrasound imaging can be useful for diagnosing acute heart failure (AHF). We aimed to evaluate the diagnostic performance of an algorithm based on point-of-care ultrasound (POCUS) in patients coming to the emergency department with acute dyspnea. Methods. Prospective analysis of a convenience sample of patients with acute dyspnea in 2 hospital emergency departments. The POCUS algorithm included lung ultrasound findings and 3 echocardiographic measurements taken from an apical view of 4 chambers: mitral annular plane systolic excursion, Doppler mitral flow velocity, and tissue Doppler imaging of the lateral mitral annulus. The definitive diagnosis was made by 2 physicians blinded to the POCUS findings. Results. A total of 103 adult patients with a mean (SD) age of 73 (12) years were included; about half (51 patients) were women. Forty-two patients (41%) were finally diagnosed with AHF. Interindividual agreement on the physicians' diagnoses was good ( k = 0.82). The POCUS algorithm assigned an AHF diagnosis to 76 patients (74%); 56 of them (85%) were in sinus rhythm. The diagnostic performance indicators for the algorithm were as follows: area under the receiver operating characteristic curve, 0.94 (95% CI, 0.88--1.00); sensitivity 96% (95% CI, 78%--100%); specificity, 93% (95% CI, 8%--98%); positive predictive value, 85% (95% CI, 67%--100%); negative predictive value, 98% (95% CI, 88%--100%). Conclusion. The POCUS-based algorithm for diagnosing AHF performed well in patients coming to the emergency department with acute dyspnea.
- Subjects
CHEST (Anatomy); ECHOCARDIOGRAPHY; PREDICTIVE tests; HOSPITAL emergency services; CONFIDENCE intervals; POINT-of-care testing; LUNGS; PATIENTS; DYSPNEA; EMERGENCY medical services; DESCRIPTIVE statistics; STATISTICAL sampling; RECEIVER operating characteristic curves; ALGORITHMS; HEART failure; ACUTE diseases; LONGITUDINAL method; MITRAL valve
- Publication
Emergencias, 2021, Vol 33, Issue 6, p441
- ISSN
1137-6821
- Publication type
Article