title: E-point septal separation compared to fractional shortening measurements of systolic function in emergency department patients: prospective randomized study.
abstract: OBJECTIVE
  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 R2 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.
authors.affiliation: Department of Emergency Medicine, Carolinas Medical Center, 1000 Blythe Blvd, Charlotte, NC 28203, USA. anthony.weekes@carolinashealthcare.org
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Weekes
authors.forename: Abhiram
authors.initials: A
authors.lastname: Reddy
authors.forename: Margaret R
authors.initials: MR
authors.lastname: Lewis
authors.forename: H James
authors.initials: HJ
authors.lastname: Norton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D011446:Prospective Studies; D013599:Systole; D014463:Ultrasonography; D016277:Ventricular Function, Left; D055815:Young Adult