Screening and Monitoring for Cardiac Dysfunction using Echocardiography and Novice Healthcare Staff

2019 Vanguard Grant

Years funded: 2020-2021

Heart failure is a leading cause of hospitalisation, with increasing prevalence and poor outcomes partly related to treatments being applied late in the disease trajectory. We need to focus on earlier identification of structural heart disease including asymptomatic left ventricular systolic dysfunction, a well-recognised precursor of heart failure. This could be achieved by broader application of echocardiography, however there are a limited number of experienced echosonographers available to screen and monitor individuals at high-risk of developing left ventricular systolic dysfunction. The overall aim of this research is to demonstrate that novel echocardiographic techniques could facilitate accurate and cost-effective screening and monitoring for asymptomatic left ventricular systolic dysfunction by non-specialised healthcare staff such as nurses.

This could allow for earlier management to improve clinical outcomes and reduce the burden of heart failure. There are several echocardiographic methods to measure left ventricular systolic function, and recent technological advances have allowed incorporation into hand-held devices and increased automation with the potential for non-specialised healthcare staff to perform these assessments. We intend to train a series of nursing staff cohorts to perform two separate semi-automated measures of left ventricular systolic function after completing experimental focussed training.

We will compare this with echocardiographic assessment of left ventricular systolic function performed by experienced echosonographers. This will inform subsequent larger studies to evaluate the clinical effectiveness and cost effectiveness of screening and monitoring for left ventricular systolic dysfunction when performed by novice healthcare staff in high-risk patients based on their cardiovascular risk factor profile and/or receiving treatments associated with cardiotoxicity.