Abstract Background Echocardiographic assessment of left ventricular (LV) diastolic function is an essential part of the routine evaluation of patients presenting with dyspnea or impaired effort tolerance. Diagnostic algorithm of diastolic dysfunction involves pulsed and continuous wave Doppler measurements, which were not within the range of capabilities of previous generations of handheld ultrasound devices (HUD). However, implementing new modalities into HUD expanded the area in which they may thrive. Aim To verify and validate the reliability of diastolic function parameters acquired during the HUD echocardiographic examination Methods Study population consisted of the consecutive 100 pts admitted to Cardiology Emergency Room due to the dyspnea and/or impaired effort tolerance. All patients underwent brief bedside echocardiographic screening with HUD which involved the assessment of mitral inflow velocities- early (E) and late (A), septal and lateral mitral annular peak early diastolic velocity (e')- measured with the pulsed wave Doppler modality, E/E’ ratio, E/A ratio, and tricuspid regurgitation velocity (measured with the continuous wave Doppler modality). Within the next 24 hours all patients underwent full echocardiographic examination performed with the use of stationary ultrasonographic station, which results were treated as reference. Results Septal E’ did not exceed 7cm/s in 22 patients, lateral E’ was lower than 10cm/s in 24 patients. Correlation between the measurements from HUD and full echocardiography was 0,84 for septal E’ and 0,44 for lateral E’; for both parameters agreement for detection of incorrect, lowered values between methods was high (Kappa coefficient 0,751 i 0,8 respectively). E/E’ was significantly increased in 6 patients, which was detected with high agreement in HUD examination (Kappa coefficient 0,73). Correlation coefficient for E/A parameter was 0,77 and agreement categorized for each group (E/A≤0,8; E/A >0,8 & <2; E/A ≥2 ) was high (kappa coefficient 0,75; 0,74; 1,0 respectively); it is worth noting that all cases with E/A ≥2 were identified in HUD examination. TR velocity exceeded 2,8 m/s in 11pts, in this aspect the agreement between HUD and full examination was 0,65. However the positive predictive value of this parameter was 100%. Conclusion HUD equipped with a spectral doppler modality enables for reliable echocardiographic screening of LV diastolic function. Introducing the elements of imaging diagnostics to the initial assessment might markedly hasten the establishing of the final diagnosis. E/A ratio- HUD & full echocardiography HUD/fullECHO derived values correlation
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