Handheld echocardiography (HHE) performed by trained advanced practice providers (APPs) was associated with lower 30-day congestive heart failure (CHF) readmissions in hospitalized patients with CHF. The findings were reported in a prospective cohort study published in the Mayo Clinic Proceedings: Innovations, Quality and Outcomes. 

The study included 140 consecutive patients hospitalized with CHF under a cardiology service. The intervention group included 67 patients who underwent APP-guided HHE assessment. The control group included 73 retrospective controls who received standard APP-delivered care without HHE during the same period.

The intervention group underwent HHE assessment of left ventricular ejection fraction and right atrial pressure (RAP). These findings were incorporated into guideline-directed medical therapy (GDMT) decisions. Outcomes included GDMT use, hospital length of stay, and 30-day all-cause and CHF-specific readmissions.

Baseline demographic and treatment characteristics were generally comparable between groups. However, diabetes mellitus was more common in the HHE group than in controls (59.70% vs 32.88%; P<0.01). Prior stroke (26.03% vs 10.45%; P<0.05) and higher heart rate (88±22 vs 80±15 bpm; P<0.05) were more frequent in the control group.

Predischarge RAP measurements in the HHE group declined from admission values. GDMT prescription rates increased from admission to discharge in both groups. However, no significant differences were observed between groups at discharge.

Patients in the HHE group experienced fewer 30-day CHF readmissions than controls (4.5% [95% CI, 0.9%-12.5%] vs 12.3% [95% CI, 5.7%-22.1%]; P<0.05). Length of hospital stay and 30-day all-cause readmission rates were similar between groups.

The findings showed that HHE-guided assessment was associated with lower predischarge RAP and fewer short-term CHF readmissions. Larger randomized trials are needed to confirm these observations.