Value of systolic time intervals in the diagnosis of heart failure in emergency department patients with undifferentiated dyspnea.
Aged
Biomarkers
/ blood
Dyspnea
/ etiology
Echocardiography
Emergency Service, Hospital
Female
Heart Failure
/ complications
Humans
Male
Middle Aged
Natriuretic Peptide, Brain
/ blood
Prospective Studies
ROC Curve
Sensitivity and Specificity
Stroke Volume
Systole
/ physiology
Ventricular Dysfunction, Left
/ diagnosis
Ventricular Function, Left
/ physiology
Journal
International journal of clinical practice
ISSN: 1742-1241
Titre abrégé: Int J Clin Pract
Pays: India
ID NLM: 9712381
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
20
01
2020
revised:
22
05
2020
accepted:
26
05
2020
pubmed:
6
6
2020
medline:
27
1
2021
entrez:
6
6
2020
Statut:
ppublish
Résumé
The diagnosis of heart failure in the emergency department (ED) is challenging. The aim of this study was to evaluate systolic time intervals (STIs) using phonoelectrocardiography for the diagnosis of heart failure (HF) in ED patients with undifferentiated dyspnea. A total of 855 patients with dyspnea and suspected HF were prospectively enrolled. They underwent echocardiographic measurements of left ventricular ejection fraction (LVEF), B-type natriuretic peptide (BNP) testing and computerised phonoelectrocardiography to assess STIs including electromechanical activation time (EMAT), left ventricular ejection time (LVET) and EMAT/LVET ratio. Diagnosis accuracy of STIs was calculated including sensitivity, specificity, likelihood ratio and receiver operating characteristic (ROC) curve. Patients with HF (n = 530) had significantly higher EMAT and lower LVET compared with non-HF patients. ROC curve c-statistic was 0.74, 0.72 and 0.78 for EMAT, LVET and EMAT/LVET respectively. Sensitivity and specificity of EMAT/LVET at a cut-off = 40% were 72% and 88% respectively. EMAT/LVET had the highest correlation with LVEF (r = 0.48). In patients with intermediate BNP (n = 107), positive likelihood ratio increased from 1.8 with BNP alone to 3.6 with BNP combined to EMAT/LVET. Patients without HF had STIs values not significantly different from those with preserved LVEF (≥45%). Given their immediate availability, phonoelectrocardiography STIs' parameters and particularly EMAT/LVET ratio could have an important role in the diagnosis approach of HF in patients with undifferentiated dyspnea in the ED.
Substances chimiques
Biomarkers
0
Natriuretic Peptide, Brain
114471-18-0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e13572Informations de copyright
© 2020 John Wiley & Sons Ltd.
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