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Usefulness of M-mode echocardiography in the diagnosis of heart failure
J Remes1, E Länsimies, K Pyörälä
1Department of Medicine, Kuopio University Central Hospital, Finland.
Insights
M-mode echocardiography is useful for diagnosing heart failure (HF). This diagnostic tool is more effective at ruling out HF than confirming it, aiding clinical decisions.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Heart failure (HF) diagnosis requires accurate assessment.
- M-mode echocardiography is a non-invasive imaging technique.
Purpose of the Study:
- To evaluate the diagnostic utility of M-mode echocardiography in suspected heart failure.
- To determine the sensitivity and specificity of echocardiographic variables for HF detection.
Main Methods:
- Study included 70 patients with suspected HF and 63 controls (aged 45-74).
- Patients classified using Boston criteria: 'unlikely', 'possible', 'definite' HF.
- Calculated sensitivity and specificity using control group 95% confidence limits as cut-offs.
Main Results:
- Mitral valve E point-septal separation (EPSS) sensitivity: 91%, specificity: 73%.
- Left ventricular (LV) fractional shortening (FS) sensitivity: 73%, specificity: 88%.
- Peak rate of increase of LV diameter (PLR) sensitivity: 64%, specificity: 78%.
- Normal EPSS, FS, and PLR reduced 'definite' HF likelihood to 7%.
Conclusions:
- M-mode echocardiography is a valuable tool in evaluating suspected heart failure.
- The method is more reliable for excluding than confirming HF.
Abstract:
The utility of M-mode echocardiography in the diagnosis of heart failure (HF) was evaluated in a study of 70 patients with suspected HF (26 men and 44 women) and 63 control persons (26 men and 37 women), all aged 45-74 years. The patients were classified according to the certainty of HF diagnosis using the Boston criteria: 27 patients were defined as 'unlikely' to have HF, 19 as having 'possible' HF, and 24 as having 'definite' HF. In calculations of the sensitivities and specificities for echocardiographic variables in detecting 'definite' HF, the 95% confidence limits in the control group were used as cut-off point values. Sensitivities thus attained were 91% for mitral valve E point-septal separation (EPSS), 73% for left ventricular (LV) fractional shortening (FS), and 64% for peak rate of increase of LV diameter (PLR), respectively, and the specificities were 73, 88, and 78%, respectively. When EPSS, FS and PLR were all normal, the likelihood of 'definite' HF was as low as 7%. We conclude that M-mode echocardiography is actually a useful method in the diagnostic evaluation of patients with suspected HF, and it is more reliable in excluding than confirming the presence of HF.