Hand carried echocardiography screening for LV systolic dysfunction in a pulmonary function laboratory

Area of Science:

• Cardiology
• Pulmonology
• Medical Ultrasound

Background:

• Dyspnea is a common symptom in both pulmonary disease and heart failure.
• Accurate identification of left ventricular (LV) systolic dysfunction is crucial due to high heart failure morbidity.
• Pulmonary function testing (PFT) is frequently used for dyspnea evaluation.

Purpose of the Study:

• To assess the utility of hand-carried ultrasound (HCU) for screening LV systolic dysfunction in patients referred for PFT.
• To determine if HCU can accurately identify significant LV systolic dysfunction in this patient population.

Main Methods:

• A prospective study involving 49 subjects undergoing pulmonary function testing.
• Brief echocardiographic examinations were performed using a hand-carried ultrasound (HCU) device by an internist.
• All subjects subsequently underwent a gold-standard full-featured echocardiogram.

Main Results:

• No subjects with normal PFT exhibited LV systolic dysfunction.
• Among patients with abnormal PFT, 15% (6 subjects) had LV systolic dysfunction.
• HCU demonstrated high sensitivity (100%), specificity (95%), and negative predictive value (100%) for detecting LV systolic dysfunction.

Conclusions:

• LV systolic dysfunction is common in patients presenting with pulmonary disease symptoms.
• Physician-performed HCU is an accurate screening tool for LV systolic dysfunction in this cohort.
• HCU screening, followed by complete echocardiography, can improve diagnostic yield for heart failure.