Focused cardiac ultrasound for the detection of a ventricular aneurysm.
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ABSTRACT:
SUBMITTER: Bailey S
PROVIDER: S-EPMC3523894 | biostudies-literature | 2012 Sep
REPOSITORIES: biostudies-literature
Publications
Focused cardiac ultrasound for the detection of a ventricular aneurysm.
Bailey Steven S Herring Andrew A Stone Michael M Nagdev Arun A
The western journal of emergency medicine 20120901 4
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Project description:Introduction/purposeIncreasing demand for training in focused cardiac ultrasound (FCU) is constrained by availability of supervisors to supervise training on patients. We designed and tested the feasibility of a cloud-based (internet) system that enables remote supervision and monitoring of the learning curve of image quality and interpretative accuracy for one novice learner.MethodsAfter initial training in FCU (iHeartScan and FCU TTE Course, University of Melbourne), a novice submitted the images and interpretation of 30 practice FCU examinations on hospitalised patients to a supervisor via a cloud-based portal. Electronic feedback was provided by the supervisor prior to the novice performing each FCU examination, which included image quality score (for each view) and interpretation errors. The primary outcome of the study was the number of FCU scans required for two consecutive scans to score: (i) above the lower limit of acceptable total image quality score (64%), and (ii) below the upper limit of acceptable interpretive errors (15%).ResultsThe number of FCU practice examinations required to meet adequate image quality and interpretation error standard was 10 and 13, respectively. Improvement in image acquisition continued, remaining within limits of acceptable image quality. Conversely, interpretive in-accuracy (error > 15%) continued.ConclusionThis electronic FCU mentoring system circumvents (but should not replace) the requirement for bed-side supervision, which may increase the capacity of supervision of physicians learning FCU. The system also allows real-time tracking of their progress and identifies weaknesses that may assist in guiding further training.
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Project description:ObjectiveThis study aimed to investigate the effect of left ventricular aneurysm (LVA) volume and left ventricular global torsion on cardiac function by real time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging(2D-STI), to determine the accuracy of RT-3DE and 2D-STI in assessing LV function.MethodsThirty New Zealand rabbit models of with LVA were prepared by ligation of the middle segment of the left anterior descending and left circumflex arteries. Four weeks post-procedure, RT-3DE was conducted to obtain data on LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and LVA volume (LVAV), Peak rotation angles at the mitral valve annulus level (MV-ROT), peak rotation angles at the apical level (AP-ROT), and left ventricular global torsion angles (LV-TOR) were measured by 2D-STI.ResultsCompared with controls, LVEDV and LVESV were significantly increased in the LVA group, while LVEF, MV-ROT, AP-ROT, and LV-TOR were consistently reduced (p<0.01). Moreover, LVEF correlated with LVA volume and LV torsion angle (r= -0.778 and 0.821, p<0.01). LVA volume/LVEDV had the strongest inverse relationship with LVEF (r= -0.911, p<0.01).ConclusionLVA volume, LVA volume/LVEDV, and LV torsion may be used as an indicator for evaluation of cardiac function after LVA. Moreover, LVA volume/LVEDV may be a more sensitive and reliable marker of cardiac function after LVA formation.
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