SHM Converge Scientific Abstract ePoster Gallery-Assessment of Left Atrial Enlargement in the Parasternal Long Axis by Non-Cardiologist Point-of-Care Ultrasound Users: A Comparison to the Gold Standard

Assessment of Left Atrial Enlargement in the Parasternal Long Axis by Non-Cardiologist Point-of-Care Ultrasound Users: A Comparison to the Gold Standard

Back to course

Pdf Summary

This study evaluated how well non-cardiologist point-of-care ultrasound (POCUS) users can detect left atrial enlargement (LAE) in the parasternal long axis (PLAX) view, compared with the current echocardiographic gold standard based on left atrial volume index (LAVI).<br /><br />The researchers reviewed 241 adult transthoracic echocardiograms after exclusions from 321 consecutive studies. Two PLAX-based methods were tested:  <br />1) visual estimation of LA size relative to the aorta, and  <br />2) a semi-quantitative approach using caliper measurement of the left atrial anteroposterior diameter with a 4 cm cutoff.<br /><br />Among the final cases, 29% had LAE and 16.6% had moderate to severe LAE. For detecting moderate to severe LAE, visual estimation showed moderate sensitivity and specificity, while the semi-quantitative method performed better overall. Specifically, the semi-quantitative approach had higher sensitivity (87.5%) and specificity (75.9%) than visual estimation (67.5% and 71.4%, respectively), with a much lower negative likelihood ratio, suggesting it is particularly useful for ruling out significant LAE. Negative predictive value was also very high for both methods, especially the semi-quantitative method (96.8%).<br /><br />The authors conclude that a simple 4 cm left atrial diameter cutoff in PLAX can improve detection of moderate to severe LAE by POCUS users and may be especially helpful for excluding important enlargement. These findings suggest a role for cardiac POCUS in cardiovascular risk assessment, early disease detection, and monitoring. However, limitations include potential examiner bias, use of caliper-based estimates instead of formal echocardiographic measurements, and uncertain generalizability to typical non-cardiologist POCUS users.

Asset Subtitle

Sofia Quintero

Meta Tag

Author List Austin C. Wilson, Brian Shahan, Christopher J. Smith, Elizabeth Lyden, Jana L. Wardian, Jesse Umbra, Kaylee Schwasinger, Nidhish Tiwari, Samuel Frankel, Sofia Quintero

Category Research

Concept Left Atrial Enlargement

Concept Atrial Fibrillation

Concept Stroke

Concept Heart Failure

Concept Point-of-Care Ultrasound

Distinguished Non-Finalist

Presenter Organization University of Nebraska Medical Center

Presenting Author Sofia Quintero

Track Technology in Hospital Medicine

Keywords

point-of-care ultrasound

POCUS

left atrial enlargement

parasternal long axis

left atrial volume index

echocardiography

semi-quantitative measurement

4 cm cutoff

sensitivity and specificity

cardiovascular risk assessment

Left Atrial Enlargement

Atrial Fibrillation

Stroke

Heart Failure

Point-of-Care Ultrasound