ABSTRACT
Miniaturization of ultrasound equipment has led to the development of hand-held echocardiography devices suitable for bedside evaluation of cardiac function. Basic assessment of the haemodynamic state can be performed using a limited transthoracic echocardiography examination. This study evaluated a third generation device (SonoSite Titan) used by novice and expert operators. Limited transthoracic examination was performed on 30 healthy volunteers by an expert and a novice operator. The novice had performed 10 studies prior to data accrual. Agreement analysis was performed using weighted least products regression and Bland-Altman analysis. Acceptable results for the novice were achieved following 20 studies (including practice sessions) for basic haemodynamic assessment and following 40 studies for all measured parameters. The SonoSite Titan is acceptable for basic transthoracic measurements to determine the basic haemodynamic state and cardiac output measurements. We recommend a minimum of 20 training studies for novice operators prior to clinical use.
Subject(s)
Clinical Competence , Echocardiography/standards , Hemodynamics , Point-of-Care Systems/standards , Adolescent , Adult , Echocardiography/instrumentation , Education, Medical, Undergraduate/methods , Humans , Middle Aged , Radiology/education , VictoriaABSTRACT
The study aimed to evaluate whether a significant difference exists between tissue harmonic imaging (THI) and fundamental imaging (FI) in routine quantitative echocardiographic assessment. We also examined the effects of THI on endocardial definition (ED). Fifty-eight unselected patients (29 men, 29 women; mean age 53 years) referred for transthoracic echocardiography were studied with use of both FI and THI modes. Two independent observers made M-mode measurements of the following: left atrium, aortic root, and left ventricular internal dimensions and wall thickness; they also measured left ventricular outflow tract diameter and left atrial area from 2-dimensional images. Endocardial definition was assessed with use of an arbitrary scoring system (0 = endocardium not visualized, 1 = endocardium visualized but suboptimally, 2 = endocardium well defined) and the American Society of Echocardiography 16-segment model. No significant difference existed between cardiac measurements derived from FI and THI. However, a highly significant improvement in ED occurred with THI (ED index 1.83 versus 1.70, P <.0001). This study suggests that no systematic differences exist in standard echocardiographic measurements between THI and FI, even in the setting of improved ED.
Subject(s)
Aorta/diagnostic imaging , Echocardiography/methods , Image Processing, Computer-Assisted/methods , Ventricular Function, Left/physiology , Adolescent , Adult , Aged , Aged, 80 and over , Embolism/diagnostic imaging , Endocarditis/diagnostic imaging , Female , Humans , Male , Middle Aged , Observer VariationABSTRACT
To evaluate the usefulness of blood testosterone (T) in monitoring the effects of therapy in congenital virilizing adrenal hyperplasia due to 21- or 11- hydroxylation defect (CVAH), T levels were measured on 45 occasions in 13 patients with CVAH; 32 urinary 17-ketosteroid levels and 31 preganetriol values were available for comparison. Bone age levels, growth data, and medication are listed to help assess the clinical state of the patient at the time of each T determination. Blood T values were above normal for age and sex in untreated patients with CVAH and declined with glucocorticoid suppression. A blood T value of 20 ng/100 ml appeared to distinguish between well-controlled cases and those with inadequate steroid suppression. Serial measurement of blood T in girls and in prepubertal boys with CVAH provides assistance in evaluating chemical control of the disease, particularly when accurate 24-h urine collections cannot be obtained for 17-ketosteroid and pregnanetriol assessments.