Hand-held cardiac ultrasound examinations performed in primary care patients by nonexperts to identify reduced ejection fraction

Abstract

Abstract Background Early identification of patients with reduced left ventricular ejection fraction (LVEF) could facilitate the care of patients with suspected heart failure (HF). We examined if (1) focused cardiac ultrasound (FCU) performed with a hand-held device (Vscan 1.2) could identify patients with LVEF 125 ng/L and fulfilling the criteria for HF (68/94), HF with preserved LVEF (≥50%) predominated, followed by mid-range (40–49%) or reduced LVEF (< 40%) HF types (53.2, 11.7 and 7.4%, respectively). Conclusions There was poor agreement between expert examiners using standard ultrasound equipment and non-experts using a handheld ultrasound device to identify patients with reduced LVEF. Asides from possible shortcomings of the training programme, the poor performance of non-experts could be explained by their limited experience in identifying left ventricular dysfunction because of the low percentage of patients with HF and reduced ejection fraction seen in the primary care setting. Trial registration The study was registered at ClinicalTrials.gov (NCT02939157). Registered 19 October 2016.

Keywords

• Echocardiography
• Heart failure
• Primary care
• Clinical trial