Left ventricular ejection fraction assessment by non-cardiologists from transverse views using a simplified wall motion score index.
Real Lebeau, Georgetta Sas, Malak El Rayes, Alexandrina Serban, Sherif Moustafa, Btissama Essadiqi, Maria DiLorenzo, Vicky Souliere, Yanick Beaulieu, Claude Sauve, Robert Amyot, Karim Serri
Author Information
Real Lebeau: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Georgetta Sas: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Malak El Rayes: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Alexandrina Serban: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Sherif Moustafa: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Btissama Essadiqi: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Maria DiLorenzo: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Vicky Souliere: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Yanick Beaulieu: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Claude Sauve: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Robert Amyot: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
Karim Serri: Hôpital du Sacré-Coeur de Montréal, Université de Montréal , 5400 Boulevard Gouin Ouest, Montréal, Quebec , Canada H4J-1C5.
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.
