Automatic tablet-based monoplane quantification of stroke volume and left ventricular ejection fraction: A comparative assessment against computer-based biplane and monoplane tools.

ABSTRACT

BACKGROUND: Point-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. METHODS: Patients 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. RESULTS: Out 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% [3.156.61] for LVEF and 17.46 mL [12.9921.92] for SV. The limits of agreement (LOA) were [-5.5015.26]% for LVEF and [-8.0242.94] mL for SV. The bias between AutoEF and AS-bi was 6.63% [5.317.94] for LVEF and 20.62 mL [16.1825.05] for SV, with LOA of [-1.2014.47]% for LVEF and [-4.7145.94] mL for SV. CONCLUSION: LVEF 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.