在患有充血性心力衰竭的患者中,先进实践提供者的手持心声谱
Maria Cecilia Tagle-Cornell1, Barbara S Novais1, Songnan Wen1
1Division of Echocardiography, Department of Cardiovascular Medicine, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054, USA.
Journal of clinical medicine
|January 23, 2024
概括
训练有素的高级实践提供者 (APP) 可以有效地使用手持心声回声学 (HHE) 来评估住院结血性心力衰竭 (CHF) 患者的左心室喷射率 (LVEF) 和右心房压力 (RAP),从而改善及时治疗.
科学领域:
- 心脏病学 心脏病学
- 护理中心超声波检查
- 高级实践提供者教育教育提供者
背景情况:
- 充血性心力衰竭 (CHF) 显著增加住院和死亡率.
- 标准心声回声图 (SE) 对于心脏评估至关重要,但往往缺乏立即可用性.
- 快速评估住院的CHF患者对于及时启动治疗至关重要.
研究的目的:
- 为了评估手持心声回声学 (HHE) 的图像质量和解释准确性,由训练有素的先进实践提供者 (APP) 在住院的CHF患者中进行.
- 为了将HHE的APP解释与专家心声学家的评估和标准心声学 (SE) 发现进行比较.
- 确定HHE在评估左心室 (LV) 大小,LV喷射率 (LVEF) 和右心房压力 (RAP) 的实用性.
主要方法:
- 五名训练有素的APP在六个月内对80名住院的CHF患者进行了HHE.
- 应用程序从HHE图像中解释了LV大小,LVEF和RAP.
- 一项研究中的心声学家盲目审查和解释HHE图像,并将其与APP和SE发现进行比较.
- 使用卡帕统计数据和相关系数来评估一致性和相关性.
主要成果:
- APPs对HHE的解释与LVEF的研究心声学家和SE (分别为0.79和0.74的kappa) 有很好的一致性.
- 在APP的RAP解释方面观察到良好的一致性 (kappa 0.67).
- 在由HHE和SE评估的LVEF之间发现了强烈的相关性 (r = 0.88,p < 0.0001).
结论:
- 经过培训的APP可以获得诊断质量的HHE图像,用于评估CHF患者的LV功能和RAP.
- 应用程序的HHE解释表明与专家评估有很好的一致性.
- 经过培训的APP提供的HHE为加快和优化CHF患者管理提供了宝贵的工具.
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