Concordancia de la evaluación ecocardiográfica básica funcional del ventrículo izquierdo entre médicos no expertos y cardiólogos especialistas en ecocardiografía

Abstract

IntroductionThe clinical decisions of patients in the intensive care unit are based on the integration of the clinical history and complementary tests. The echocardiographic evaluation can reveal decisive information in the interventions and in the prognosis of the patients. ObjectiveTo determine the concordance in the analysis of left ventricular systolic function performed by physicians with basic training in echocardiography compared with the assessment by expert cardiologists. MethodologyCross-sectional study of diagnostic concordance with prospective recruitment. Patients hospitalized in the intensive care unit during 2023 in a university clinic with a high level of complexity were included. The concordance between the trained physician and the expert was analyzed using the Kappa index (κ) for the qualitative variables, and the intraclass correlation coefficient for the quantitative ones. Results131 patients were included, with a mean age of 62 years. The concordance of the echocardiographic assessment was determined, finding very good concordance for left ventricular contractility (κ: 0.97), pericardial effusion (κ: 0.82) and its location (κ: 0.85), contractility disorders (κ: 0.84) and in the quantitative measurement of the ejection fraction (intraclass correlation coefficient: 0.91). ConclusionsThere is agreement in the evaluation of left ventricular systolic function in patients hospitalized in the intensive care unit by non-expert medical personnel with training and expert cardiologists. The results should be interpreted as part of a comprehensive assessment at the patient's bedside and not as an isolated diagnosis, always under quality standards and with the necessary verification.