Análisis ecocardiográfico de la función sistólica del ventrículo izquierdo por médicos no cardiólogos con un dispositivo de bolsillo

Abstract

A cross-sectional study, three residents not included cardiologists and were given basic training in echocardiography (theoretical hours 22 hours 65 practices), with recommendations of the American Society of Echocardiography and contributions of problem-based learning, with the development of technical competence and necessary diagnostic, analysis of agreement between residents and experts echocardiography was performed, 122 hospitalized patients who met the inclusion and exclusion criteria were collected, they were performed by conventional echocardiography and echocardiographic assessment expert by the resident, the acoustic window, contractility and left ventricular function, pericardial effusion was assessed. The hypothesis was to obtain a moderate agreement. Results: The inter observer agreement for myocardial contractility (Kappa: 0.57 p = 0.000) was analyzed left ventricular systolic function (Kappa 0.54 p = 0.000) where this moderate to be between 0.40 to 0.60 and with high statistical significance for the quality of the acoustic window (Kappa: 0.22 p = 0.000) and presence of pericardial effusion (Kappa: 0.26 p = 0.000) was found poor concordance was reaching between 0.20 - 0.40. A sensitivity of 90%, specificity 67%, positive predictive value of 80% and a negative predictive value of 85% for the diagnosis of left ventricular systolic dysfunction performed by residents was established.