Effect of Handheld Echocardiography by Trained Advanced Practice Providers on Heart Failure Management and Readmissions

Objective: To evaluate the effect of point-of-care ultrasound using handheld echocardiography (HHE) by trained advanced practice providers (APPs) on congestive heart failure (CHF) readmissions. Patients and Methods: This prospective cohort study comprised 140 consecutive patients with CHF admitted under cardiology service and involved an intervention group (n=67), in whom APPs trained in HHE assessed left ventricular ejection fraction and right atrial pressure (RAP) using HHE, and a control group (n=73) identified retrospectively during concurrent period, who received standard APP-delivered care without HHE. Advanced practice providers incorporated HHE findings into guideline-directed medical therapy (GDMT) decisions. Clinical characteristics, GDMT, length of stay, and 30-day all-cause and CHF readmissions were evaluated. Results: <.05). Length of stay and 30-day all-cause readmissions were similar n both groups. Conclusion: In patients hospitalized with CHF, the addition of HHE-guided assessment by APPs was associated with lower predischarge RAP and reduced 30-day readmissions for CHF exacerbations. These hypothesis generating findings require validation in larger randomized trials.