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Decision support for assessment of left ventricular diastolic function
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Thoracic and Vascular Surgery.
Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Clinical Physiology in Linköping.
2018 (English)In: Physiological Reports, E-ISSN 2051-817X, Vol. 6, no 16Article in journal (Refereed) Published
Abstract [en]

Echocardiographic assessment of the left ventricular diastolic function (LVDF), an integrated part of evaluation of left ventricular function is still a delicate task and is performed with substantial inter-rater variability. Therefore, we aimed to create and evaluate a guidelines-based automated decision support. An algorithm was created for a hierarchical analysis of LVDF based on variables as recommended by the latest guidelines. Age-adjusted normal ranges were pooled from previously published studies into an integrated reference table. For proof-of-concept, 20 echocardiographic examinations were analyzed offline by four experienced physicians with more than 10 years of echocardiographic experience. The first assessments were to be performed as they would be in the clinical practice. Six months later, the assessments were repeated based on the 2017 ASE/EACVI guidelines. The overall inter-rater agreement for the first clinical assessments was moderate, while the guidelines-based assessments had only fair inter-rater agreement. Both kinds of manual assessment had poor agreement with the standardized automated assessment algorithm of LVDF. In conclusion, the presented automated decision support for evaluation of diastolic LV function by Doppler echocardiography is mainly based on current guidelines involving multiple parameters in combination. Incorporating age dependency aspects in our program (available for use at https://liu.se/en/research/left-ventricular-diastolic-function-decision-support) enhances the accuracy of the evaluation and reduces variability in evaluation of LVDF. The large inter-rater variation in classification in this study also underscores the usefulness of tools to support a standardized evaluation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018. Vol. 6, no 16
Keywords [en]
Diastolic function; echocardiography; left ventricular function
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:liu:diva-156004DOI: 10.14814/phy2.13815ISI: 000442995200006PubMedID: 30125045Scopus ID: 2-s2.0-85052538225OAI: oai:DiVA.org:liu-156004DiVA, id: diva2:1301260
Available from: 2019-04-01 Created: 2019-04-01 Last updated: 2019-10-15Bibliographically approved

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Tamás, Éva

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Division of Cardiovascular MedicineFaculty of Medicine and Health SciencesDepartment of Thoracic and Vascular SurgeryDepartment of Clinical Physiology in Linköping
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