Automatic Tablet-Based Monoplane Quantification of Stroke Volume and Left Ventricular Ejection Fraction: A Comparative Assessment against Computer-Based Biplane and Monoplane Tools

• DOI: 10.22541/au.172114790.06676467/v1
• Publication Date: 2024-07-16T16:38:40Z
• Authors: P. Bingley; S. Bouwmeester; S.E.A. Felix; Leon. J. Montenij; Arthur Bouwman; Frederique Raat
• Keywords: Male; Heart Ventricles; Point-of-Care Systems; Heart Ventricles/diagnostic imaging; Echocardiography/methods; Ventricular Function, Left; Ventricular Dysfunction, Left; 03 medical and health sciences; 0302 clinical medicine; Image Interpretation, Computer-Assisted; Ventricular Dysfunction; Computer-Assisted/methods; Ventricular Function; Humans; Image Interpretation; Left/physiopathology; Aged; Computers; Handheld; Left/physiology; Reproducibility of Results; Stroke Volume; point of care ultrasound; Middle Aged; tablet-based; Stroke Volume/physiology; Echocardiography; stroke volume; Computers, Handheld; Female; monoplane cardiac function quantification; handheld ultrasound; Software

AbstractBackgroundPoint‐of‐care cardiovascular left ventricle ejection fraction (LVEF) quantification is established, but automatic tablet‐based stroke volume (SV) quantification with handheld ultrasound (HAND) devices is unexplored. We evaluated a tablet‐based monoplane LVEF and LV volume quantification tool (AutoEF) against a computer‐based tool (Tomtec) for LVEF and SV quantification.MethodsPatients underwent HAND scans, and LVEF and SV were quantified using AutoEF and computer‐based software that utilized either apical four‐chamber views (Auto Strain‐monoplane [AS‐mono]) or both apical four‐chamber and apical two‐chamber views (Auto Strain‐biplane [AS‐bi]). Correlation and Bland–Altman analysis were used to compare AutoEF with AS‐mono and AS‐bi.ResultsOut of 43 participants, eight were excluded. AutoEF showed a correlation of .83 [.69:.91] with AS‐mono for LVEF and .68 [.44:.82] for SV. The correlation with AS‐bi was .79 [.62:.89] for LVEF and .66 [.42:.81] for SV. The bias between AutoEF and AS‐mono was 4.88% [3.15:6.61] for LVEF and 17.46 mL [12.99:21.92] for SV. The limits of agreement (LOA) were [−5.50:15.26]% for LVEF and [−8.02:42.94] mL for SV. The bias between AutoEF and AS‐bi was 6.63% [5.31:7.94] for LVEF and 20.62 mL [16.18:25.05] for SV, with LOA of [−1.20:14.47]% for LVEF and [−4.71:45.94] mL for SV.ConclusionLVEF quantification with AutoEF software was accurate and reliable, but SV quantification showed limitations, indicating non‐interchangeability with neither AS‐mono nor AS‐bi. Further refinement of AutoEF is needed for reliable SV quantification at the point of care.