FOCUS ASSESSED ECHOCARDIOGRAPHY PERFORMED BY INEXPERIENCED EXAMINERS IN A CARDIAC INTENSIVE CARE UNIT

Focus assessed echocardiography (FATE) provides an excellent possibility to evaluate basic haemodynamic determinants, such as preload, afterload, contractility, compliance and relaxation, by observing obvious pathology, assessing wall thickness and chamber dimensions, biventricular function, and pleura, and relating the acquired information to the clinical situation. The goal of this study was to evaluate the applicability of FATE protocol in cardiac ICU when it was performed by inexperienced examiner. A total of 101 patients with acute myocardial infarction (AMI) were enrolled in the study. All AMI subjects were examined by two examiners with no previous experience in ultrasound using standard FATE protocol with addition of inferior vena cava (IVC) and aortic views. Data collected by inexperienced examiners was compared with the data from echocardiography performed by a cardiologist. We acquired a mean number of 5.75 ± 1.2 informative echo windows for each patient of 7 used in protocol. Mean number of informative echo windows acquired for one patient was greater in the non-smoker compared to no respiratory disease patient group (6.0 ± 1.2 vs 5.3 ± 1.8; p = 0.032). Quantitative echo measurements from inexperienced examiners correlated with measurements conducted by a cardiologist: LVEDD (R = 0.74; p 0.01); IVSd (R = 0.71; p 0.01); LVPWd (R = 0.61; p 0.01). Substantial inter-observer agreement was observed for evaluation of diastolic function (K = 0.68; p 0.01) and presence of pleural effusion (K = 0.76; p 0.01).