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

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 41; no. 8; pp. e15904 - n/a
• Main Authors: Raat, Frederique M., Bingley, Peter, Bouwmeester, Sjoerd, Felix, Suzanne E. A., Montenij, Leon J., Bouwman, Arthur R.
• Format: Journal Article
• Language: English
• Published: United States 01-08-2024
• Subjects: Aged; Computers, Handheld; Echocardiography - methods; Female; handheld ultrasound; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Image Interpretation, Computer-Assisted - methods; Male; Middle Aged; monoplane cardiac function quantification; point of care ultrasound; Point-of-Care Systems; Reproducibility of Results; Software; stroke volume; Stroke Volume - physiology; tablet‐based; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - physiopathology; Ventricular Function, Left - physiology; tablet‐based; point of care ultrasound; handheld ultrasound; monoplane cardiac function quantification; stroke volume
• DOI: 10.1111/echo.15904
• EISSN: 1540-8175
• ISSN: 0742-2822; 1540-8175

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% [3.15:6.61] 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.
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.
Point‐of‐care cardiovascular left ventricle ejection fraction quantification with a tablet based tool is established. However, further refinement is needed to quantify stroke volume with a tablet based tool.