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Left ventricular ejection fraction assessment by non-cardiologists from transverse views using a simplified wall motion score index

Echo Research & Practice volume 2, pages 1–8 (2015)Cite this article

Abstract

For the non-cardiologist emergency physician and intensivist, performing an accurate estimation of left ventricular ejection fraction (LVEF) is essential for the management of critically ill patients, such as patients presenting with shock, severe respiratory distress or chest pain. Our objective was to develop a semi-quantitative method to improve visual LVEF evaluation. A group of 12 sets of transthoracic echocardiograms with LVEF in the range of 18–64% were interpreted by 17 experienced observers (PRO) and 103 untrained observers or novices (NOV), without previous training in echocardiography. They were asked to assess LVEF by two different methods: i) visual estimation (VIS) by analysing the three classical left ventricle (LV) short-axis views (basal, midventricular and apical short-axis LV section) and ii) semi-quantitative evaluation (base, mid and apex (BMA)) of the same three short-axis views. The results for each of these two methods for both groups (PRO and NOV) were compared with LVEF obtained by radionuclide angiography. The semi-quantitative method (BMA) improved estimation of LVEF by PRO for moderate LV dysfunction (LVEF 30–49%) and normal LVEF. The visual estimate was better for lower LVEF (<30%). In the NOV group, the semi-quantitative method was better than than the visual one in the normal group and in half of the subjects in the moderate LV dysfunction (LVEF 30–49%) group. The visual estimate was better for the lower LVEF (ejection fraction <30%) group. In conclusion, semi-quantitative evaluation of LVEF gives an overall better assessment than VIS for PRO and untrained observers.

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Funding

This work was supported by the Echocardiography Laboratory of the Hôpital du Sacré-Coeur de Montréal.

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Authors and Affiliations

  1. Hôpital du Sacré-Coeur de Montréal, Université de Montréal, 5400 Boulevard Gouin Ouest, Montréal, Quebec, H4J-1C5, Canada

    Real Lebeau MD, Georgetta Sas MD, Malak El Rayes MD, Alexandrina Serban MD, Sherif Moustafa MD, Btissama Essadiqi MD, Maria DiLorenzo MD, Vicky Souliere MD, Yanick Beaulieu MD, Claude Sauve MD, Robert Amyot MD & Karim Serri MD

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  1. Real Lebeau MD
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  2. Georgetta Sas MD
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Correspondence to Real Lebeau MD.

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Lebeau, R., Sas, G., El Rayes, M. et al. Left ventricular ejection fraction assessment by non-cardiologists from transverse views using a simplified wall motion score index. Echo Res Pract 2, 1–8 (2015). https://doi.org/10.1530/ERP-14-0003

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Echo Research & Practice

ISSN: 2055-0464

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