In a recent study conducted over six months, five trained advanced practice providers (APPs) performed handheld echocardiography (HHE) on hospitalized patients with congestive heart failure (CHF) to assess key cardiac parameters, including left ventricular (LV) size, LV ejection fraction (LVEF), and right atrial pressure (RAP). The goal was to evaluate whether HHE, a more accessible tool compared to the gold standard echocardiogram (SE), could provide reliable and rapid assessments to expedite treatment decisions. The APPs' interpretations were compared with those of a study echocardiographer, who blindly reviewed the same HHE images, as well as with the findings from standard echocardiograms.

The study included 80 CHF patients with an average age of 73 years, 58% of whom were male. The patients had an average LVEF of 45% as measured by SE, and over 36% had a body mass index of 30 kg/m² or higher. The results showed strong agreement between the APPs and the study echocardiographer in interpreting LVEF (kappa 0.79) and RAP (kappa 0.67). Additionally, the APPs' HHE-based assessments of LVEF aligned well with the SE findings (kappa 0.74). The correlation between the study echocardiographer’s HHE and SE measurements of LVEF was particularly strong, with a correlation coefficient of 0.88.

These findings suggest that trained APPs can effectively use HHE to obtain diagnostic-quality images and accurately assess LV function and RAP in CHF patients. The high level of agreement with expert interpretations and standard echocardiography supports the use of HHE as a practical tool for rapid evaluation in hospitalized CHF patients, enabling timely and optimized treatment decisions. This approach could help bridge gaps in cardiac assessment, particularly in settings where standard echocardiography is not immediately available.