ABSTRACT
INTRODUCTION AND OBJECTIVES: Hand-held echocardiographic devices have recently become available. Our objective was to determine, on the basis of clinical data and basic diagnostic techniques, whether hand-held devices offer additional information useful not provided by the initial cardiovascular diagnosis. PATIENTS AND METHOD: We prospectively studied the presence and severity (absent, mild, significative) of 7 frequent heart diseases (aortic or mitral stenosis-regurgitation, tricuspid regurgitation, and left ventricular systolic dysfunction-hypertrophy) in 36 consecutive patients (50% men; mean age 68 12 years) with 3 different methods: clinical examination and basic complementary exams, hand-held echocardiography with 2D and color Doppler imaging (OptiGo, Philips Medical Systems, The Netherlands) and a standard, last-generation transthoracic echocardiogram (Sonos 550, Philips Medical Systems, The Netherlands). We compared the results obtained with the first two methods, and combined the results of both to compare these findings against the results obtained with standard electrocardiography. Percentage agreement and Somer's D, a measure of association between ordinal variables, were calculated. RESULTS: The hand-held device obtained better results than clinical examination (agreement 87 vs. 65%; D = 0.79 0.04 vs. 0.19 0.53) and identified severe lesions that were classified incorrectly by clinical examination in 39% (14/36) patients. However, in 8 patients (10 evaluations) it misclassified severe lesions. CONCLUSIONS: In experienced hands, a hand-held echocardiographic device offers additional information not obtained from an initial cardiovascular diagnosis for common cardiovascular disorders, but it is no substitute for complete echocardiographic examination.
Subject(s)
Cardiovascular Diseases/diagnosis , Echocardiography, Doppler, Color/instrumentation , Aged , Echocardiography, Doppler, Color/methods , Equipment and Supplies , Evaluation Studies as Topic , Female , Humans , MaleABSTRACT
Introducción y objetivos. Desde hace poco tiempo disponemos de nuevos sistemas portátiles de ecocardiografía. Nuestro objetivo es determinar si un ecocardiograma portátil aporta información suplementaria al diagnóstico cardiovascular inicial, basado en datos clínicos y técnicas diagnósticas básicas. Pacientes y método. Estudiamos prospectivamente la presencia y severidad (ausente, leve, significativa) de 7 cardiopatías frecuentes: estenosis-insuficiencia aórtica y mitral, insuficiencia tricuspídea y disfunción-hipertrofia ventricular izquierda en pacientes consecutivos mediante 3 técnicas distintas: valoración clínica junto con pruebas complementarias básicas, ecocardiograma portátil con imagen 2D y Doppler color (Optigo®, Philips Medical Systems) y ecocardiograma estándar de última generación (Sonos 5500®, Philips Medical Systems). Comparamos los resultados obtenidos mediante las primeras 2 técnicas y combinando los resultados de ambas, respecto al ecocardiograma estándar, mediante el porcentaje de concordancia y la medida de asociación D de Somers. Resultados. Estudiamos a 36 pacientes (50 por ciento varones; edad, 68 ñ 12 años). El ecocardiograma portátil obtuvo mejores resultados que la valoración clínica (concordancia del 87 frente al 65 por ciento; D = 0,79 ñ 0,04 frente a 0,19 ñ 0,53) e identificó lesiones significativas incorrectamente valoradas por la clínica en un 39 por ciento (14/36) de los pacientes; sin embargo, en 8 pacientes (10 valoraciones) valoró erróneamente lesiones significativas. Conclusiones. El ecocardiograma portátil, en manos experimentadas, aporta información adicional al diagnóstico inicial de enfermedades cardiovasculares comunes, pero no resulta equivalente a un diagnóstico ecocardiográfico completo (AU)
