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. 1995 Mar 11;310(6980):634–636. doi: 10.1136/bmj.310.6980.634

Open access echocardiography in management of heart failure in the community.

C M Francis 1, L Caruana 1, P Kearney 1, M Love 1, G R Sutherland 1, I R Starkey 1, T R Shaw 1, J J McMurray 1
PMCID: PMC2549011  PMID: 7503841

Abstract

OBJECTIVE--To assess the value of an open access echocardiography service. DESIGN--Study of new open access service for general practitioners, who were invited to refer patients taking diuretics for suspected heart failure, untreated patients with symptoms of possible heart failure, and asymptomatic patients with risk factors for left ventricular systolic dysfunction. SETTING--Regional cardiology centre. SUBJECTS--259 consecutive patients. MAIN OUTCOME MEASURES--Presence or absence of left ventricular systolic dysfunction and consequent changes in clinical management. RESULTS--119 treated patients, 99 untreated patients, and nine asymptomatic patients were referred over five months. 32 were considered to be inappropriately referred. Among the treated patients, 31 had impaired left ventricular systolic function and five had valvular disease; angiotensin converting enzyme inhibitors were recommended for 34 of these patients. In addition, 53 were thought not to need diuretics. Eight untreated patients had impaired systolic function and six valvular disease. CONCLUSIONS--The service was well used by general practitioners and led to advice to change management in more than two thirds of patients.

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Selected References

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  1. Albin G., Rahko P. S. Comparison of echocardiographic quantitation of left ventricular ejection fraction to radionuclide angiography in patients with regional wall motion abnormalities. Am J Cardiol. 1990 Apr 15;65(15):1031–1032. doi: 10.1016/0002-9149(90)91009-u. [DOI] [PubMed] [Google Scholar]
  2. Bramble M. G., Cooke W. M., Corbett W. A., Cann P. A., Clarke D., Contractor B., Hungin A. S. Organising unrestricted open access gastroscopy in South Tees. Gut. 1993 Mar;34(3):422–427. doi: 10.1136/gut.34.3.422. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Choy A. M., Darbar D., Lang C. C., Pringle T. H., McNeill G. P., Kennedy N. S., Struthers A. D. Detection of left ventricular dysfunction after acute myocardial infarction: comparison of clinical, echocardiographic, and neurohormonal methods. Br Heart J. 1994 Jul;72(1):16–22. doi: 10.1136/hrt.72.1.16. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clarke K. W., Gray D., Hampton J. R. Evidence of inadequate investigation and treatment of patients with heart failure. Br Heart J. 1994 Jun;71(6):584–587. doi: 10.1136/hrt.71.6.584. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Dargie H. J., McMurray J. J. Diagnosis and management of heart failure. BMJ. 1994 Jan 29;308(6924):321–328. doi: 10.1136/bmj.308.6924.321. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigattors. N Engl J Med. 1992 Sep 3;327(10):685–691. doi: 10.1056/NEJM199209033271003. [DOI] [PubMed] [Google Scholar]
  7. Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. The SOLVD Investigators. N Engl J Med. 1991 Aug 1;325(5):293–302. doi: 10.1056/NEJM199108013250501. [DOI] [PubMed] [Google Scholar]
  8. Gaasch W. H. Diagnosis and treatment of heart failure based on left ventricular systolic or diastolic dysfunction. JAMA. 1994 Apr 27;271(16):1276–1280. [PubMed] [Google Scholar]
  9. Kerrigan D. D., Brown S. R., Hutchinson G. H. Open access gastroscopy: too much to swallow? BMJ. 1990 Feb 10;300(6721):374–376. doi: 10.1136/bmj.300.6721.374. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. McClements B. M., Campbell N. P., Cochrane D., Stockman S. Direct access exercise electrocardiography: a new service that improves the management of suspected ischaemic heart disease in the community. Br Heart J. 1994 Jun;71(6):531–535. doi: 10.1136/hrt.71.6.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Pfeffer M. A., Braunwald E., Moyé L. A., Basta L., Brown E. J., Jr, Cuddy T. E., Davis B. R., Geltman E. M., Goldman S., Flaker G. C. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. N Engl J Med. 1992 Sep 3;327(10):669–677. doi: 10.1056/NEJM199209033271001. [DOI] [PubMed] [Google Scholar]
  12. Remes J., Miettinen H., Reunanen A., Pyörälä K. Validity of clinical diagnosis of heart failure in primary health care. Eur Heart J. 1991 Mar;12(3):315–321. doi: 10.1093/oxfordjournals.eurheartj.a059896. [DOI] [PubMed] [Google Scholar]
  13. St John Sutton M., Pfeffer M. A., Plappert T., Rouleau J. L., Moyé L. A., Dagenais G. R., Lamas G. A., Klein M., Sussex B., Goldman S. Quantitative two-dimensional echocardiographic measurements are major predictors of adverse cardiovascular events after acute myocardial infarction. The protective effects of captopril. Circulation. 1994 Jan;89(1):68–75. doi: 10.1161/01.cir.89.1.68. [DOI] [PubMed] [Google Scholar]
  14. Thomas J. D., Weyman A. E. Echocardiographic Doppler evaluation of left ventricular diastolic function. Physics and physiology. Circulation. 1991 Sep;84(3):977–990. doi: 10.1161/01.cir.84.3.977. [DOI] [PubMed] [Google Scholar]
  15. Wheeldon N. M., MacDonald T. M., Flucker C. J., McKendrick A. D., McDevitt D. G., Struthers A. D. Echocardiography in chronic heart failure in the community. Q J Med. 1993 Jan;86(1):17–23. [PubMed] [Google Scholar]
  16. Zermansky A. Open access gastroscopy. GPs use gastroscopy appropriately. BMJ. 1993 Jun 26;306(6894):1750–1751. doi: 10.1136/bmj.306.6894.1750-b. [DOI] [PMC free article] [PubMed] [Google Scholar]

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