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Heart failure and cardiomyopathies
Original research
Accuracy of visual estimation of ejection fraction in patients with heart failure using augmented reality glasses
  1. Sungwoo Choi1,
  2. Sangun Nah1,
  3. Young Soon Cho1,
  4. Inki Moon2,
  5. Jae Wook Lee3,
  6. Choung Ah Lee4,
  7. Ji Eun Moon5,
  8. Sangsoo Han1
  1. 1Department of Emergency Medicine, Soonchunhyang University Hospital Bucheon, Bucheon, Korea (the Republic of)
  2. 2Department of Cardiology, Soonchunhyang University Hospital Bucheon, Bucheon, Korea (the Republic of)
  3. 3Department of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon, Korea (the Republic of)
  4. 4Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea (the Republic of)
  5. 5Department of Biostatistics, Soonchunhyang University Hospital Bucheon, Bucheon, Korea (the Republic of)
  1. Correspondence to Dr Sangsoo Han, Emergency Medicine, Soonchunhyang University Hospital Bucheon, Bucheon 14584, Gyeonggi-do, Korea (the Republic of); brayden0819{at}daum.net

Abstract

Objective Left ventricular ejection fraction (LVEF) is measured to assess haemodynamic status and cardiac function. It may be difficult to accurately measure in patients with heart failure (HF) as they are often poorly echogenic. The augmented reality (AR) technology is expected to provide real-time guidance that will enable more accurate measurements.

Methods A prospective, randomised, case-crossover simulation study was conducted to confirm the effect of AR glasses on echocardiographic interpretation in patients with HF. 22 emergency physicians participated. The participants were randomly assigned to two groups. Group A estimated the visual ejection fraction of echocardiographic video clips without the AR glasses, while group B estimated them with glasses. After a washout period, the two groups crossed over. The estimates were then compared with the ejection fraction measurements obtained by echocardiologists; intraclass correlation coefficient (ICC) was calculated.

Results The ICC with glasses (0.969, 95% CI 0.966 to 0.971) was higher than without glasses (0.705, 95% CI 0.681 to 0.727) among all participants. In the subgroup analysis, the first-year and second-year residents showed the most significant difference, with an ICC of 0.568 (95% CI 0.508 to 0.621) without glasses compared with 0.963 (95% CI 0.958 to 0.968) with glasses. For the third-year and fourth-year residents group, the ICC was 0.754 (95% CI 0.720 to 0.784) without glasses and 0.972 (95% CI 0.958 to 0.968) with glasses. Among the group of attending physicians, the ICC was 0.807 (95% CI 0.775 to 0.834) without glasses and 0.973 (95% CI 0.969 to 0.977) with glasses.

Conclusions AR glasses could be helpful in measuring LVEF and could be more helpful to those with little visual estimation experience.

  • Echocardiography
  • Heart failure

Data availability statement

Data are available upon reasonable request. The data and the materials of this study are available from the corresponding author (SH; brayden0819@daum.net) or the Institutional Review Board of Soonchunhyang University Bucheon Hospital (20200817@schmc.ac.kr) upon reasonable request.

http://dx.doi.org/10.1136/heartjnl-2023-323067

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    Data availability statement

    Data are available upon reasonable request. The data and the materials of this study are available from the corresponding author (SH; brayden0819@daum.net) or the Institutional Review Board of Soonchunhyang University Bucheon Hospital (20200817@schmc.ac.kr) upon reasonable request.

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    Footnotes

    • Twitter @rokstone

    • SC, SN and SH contributed equally.

    • Contributors SH had full access to all the data and takes responsibility for the integrity of the data and the accuracy of the data analysis. Concept and design: SC, SN, SH. Acquisition and analysis: SC, YSC, IM, JWL, CAL. Interpretation of data: SN, JEM, SH. Drafting of the manuscript: SC, SN, SH. Critical revision of the manuscript for important intellectual content: SC, IM, SH. Statistical analysis: SN, JEM. Obtaining study funding: SH. Supervision: SH. Guarantor for the manuscript: SH.

    • Funding This work was supported by the Soonchunhyang University Research Fund (grant number 2023-0057). This research was funded by the Society of Emergency and Critical Care Imaging, Republic of Korea (grant number 202201). The funders had no role in the design and conduct of the study.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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