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E‐Point Septal Separation Compared to Fractional Shortening Measurements of Systolic Function in Emergency Department Patients
Author(s) -
Weekes Anthony J.,
Reddy Abhiram,
Lewis Margaret R.,
Norton H. James
Publication year - 2012
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2012.31.12.1891
Subject(s) - medicine , parasternal line , fractional shortening , emergency department , cardiology , linear regression , clinical endpoint , separation (statistics) , cardiac function curve , randomized controlled trial , heart failure , statistics , mathematics , psychiatry
Objectives Rapid bedside assessment of left ventricular (LV) function can aid in the evaluation of the critically ill patient and guide clinical management. Our primary hypothesis was that mitral valve E‐point septal separation measurements would correlate with contemporaneous fractional shortening measurements of LV systolic function when performed by emergency physicians. Our secondary hypothesis was that E‐point septal separation as a continuous variable would predict fractional shortening using a linear regression model. Methods We studied a prospective convenience sample of patients undergoing a sequence of LV systolic function measurements during a 3‐month period at a suburban academic emergency department with a census of 114,000 patients. The sample included adult emergency department patients who were determined by the treating emergency physician to have 1 or more clinical indications for bedside LV systolic function assessment. Investigators performed bedside M‐mode cardiac sonographic measurements of fractional shortening and E‐point septal separation using the parasternal long‐axis window. The sequence of LV systolic function measurements was randomized. Results A total of 103 patients were enrolled. The Pearson correlation coefficient for E‐point septal separation and fractional shortening measurements was –0.59 ( P < .0001). Linear regression analysis performed for E‐point septal separation with fractional shortening as the dependent variable yielded an R 2 value of 0.35. Conclusions E‐point septal separation and fractional shortening measurements had a moderate negative correlation. E‐point septal separation, when used as a continuous variable in a linear regression model, did not reliably predict fractional shortening.