342 Feasibility and Accuracy of Assessing Left Ventricular Systolic Function by Measuring Left Ventricular Ejection Fraction Using a Hand-held Echocardiography Device With an Automated Algorithm

Abstract

Integration of automated algorithms for left ventricular ejection fraction (LVEF) assessment in hand-carried ultrasound (HCU) devices could permit focussed, point-of-care LVEF assessments by non-specialised staff such as monitoring for left ventricular systolic function, reducing global heart failure burden. Determine accuracy and feasibility of automated LVEF assessment using HCU integrated with a novel, AI assisted automatic single-plane LVEF algorithm (AutoEF). Nineteen patients (sinus rhythm) undergoing clinically indicated echocardiography (including standard LVEF assessments; Vivid E9; optimal image quality), had AutoEF performed within 24hrs (LVivo EF App on Vscan ExtendTM), using an apical four chamber acquisition. AutoEF measures (end-diastolic volume ‘EDV’, end-systolic volume ‘ESV’, LVEF) were compared to standard echocardiographic single-plane LVEF (SPEF) using Bland-Altman, mean differences (absolute ‘#’, relative ‘%’), and to standard 3D-echocardiographic LVEF (cut-off <50%) using receiver operating characteristic (ROC). AutoEF intraobserver reproducibility was also assessed. In the 19 patients (69% male, 55±15yrs LVEF 58±12% range 26%-68%), AutoEF had 95% feasibility (n=18). AutoEF was comparable to SPEF for EDV (Mean Bias ‘MB’ +0.5(-29,+28), 12±8ml#, 12±8%%), ESV (MB +2.8(-19,+25) -9.3±7ml#, 22±18%%), and LVEF (MB -3.8(-21,+14), 7.6±5.9%#, 15±13%%). AutoEF ROC found AUC=0.95 at ≤49% (Sensitivity 100%; Specificity 86%). AutoEF intraobserver mean differences# were 7±8ml (EDV); 4±5ml (ESV), and 1.7±1.2% (LVEF). AutoEF measurement via HCU is highly feasible and reproducible. SPEF and AutoEF were comparable, and ROC analysis suggests HCU AutoEF may allow reliable detection of reduced LVEF in patients with optimal image quality using single plane acquisition. Further investigations should evaluate accuracy when used by non-specialised staff.