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MINERVA ANESTESIOLOGICA

A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care


Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 Apr 12

DOI: 10.23736/S0375-9393.18.12249-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Assessment of left ventricular ejection fraction in critically ill patients at the time of speckle tracking echocardiography: intensivists in training for echocardiography versus experienced operators

Federico FRANCHI 1 , Matteo CAMELI 2, Fabio S. TACCONE 3, Loredana MAZZETTI 1, Elisa BIGIO 1, Martina CONTORNI 1, Sergio MONDILLO 2, Sabino SCOLLETTA 1

1 Unit of Intensive Care Medicine, Department of Medical Biotechnologies, University of Siena, Siena, Italy; 2 Unit of Cardiology, Department of Medical Biotechnologies, University of Siena, Siena, Italy; 3 Department of Intensive Care, Université Libre de Bruxelles, Hopital Erasme, Brussels, Belgium


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BACKGROUND: The biplane Simpson’s method is considered the gold standard to assess and monitor left ventricular (LV) ejection fraction (EF) in critically ill patients. Recently, a new semiautomatic technique based on speckle tracking echocardiography called “Auto-EF” has been introduced. We compared LVEF values obtained with biplane Simpson’s method and Auto-EF by two groups of operators: trainee echocardiography intensivists and experienced echocardiographers.
METHODS: A standard transthoracic echocardiography was performed on 37 patients. According to image quality 29 patients were selected. Each inexperienced and experienced operator executed an off-line analysis using both Simpson’s method and Auto-EF. LVEF obtained by the two groups of operators were then compared.
RESULTS: EF values assessed with Simpson’s method showed a moderate correlation (r = 0.70, p<0.01) between inexperienced and experienced operators. The Bland-Altman analysis showed a mean bias of 0.3% with limits of agreement (LoA) from -24.4 to +25.1%. Values obtained with Auto-EF showed a good correlation (r=0.94, p<0.01) with a mean bias of 0.2% and LoA from -10.1 to +10.4%.
CONCLUSIONS: Due to its semiautomatic nature, for inexpert operators Auto-EF seems more reproducible than the traditional Simpson’s method for monitoring left ventricular function in critically ill patients.


KEY WORDS: Echocardiography - Critically ill - Transthoracic - Haemodynamics - Intensive care Units - Left ventricular function

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Publication History

Article first published online: April 12, 2018
Manuscript accepted: April 10, 2018
Manuscript revised: April 6, 2018
Manuscript received: June 20, 2017

Cite this article as

Franchi F, Cameli M, Taccone FS, Mazzetti L, Bigio E, Contorni M, et al. Assessment of left ventricular ejection fraction in critically ill patients at the time of speckle tracking echocardiography: intensivists in training for echocardiography versus experienced operators. Minerva Anestesiol 2018 Apr 12. DOI: 10.23736/S0375-9393.18.12249-8

Corresponding author e-mail

federico.franchi@dbm.unisi.it