RESUMO
INTRODUCTION: Hand-held echocardiography (echo) (HE) was compared with standard echo (SE) to evaluate the quality of HE and to determine if it is safe to use HE to screen for left ventricular systolic dysfunction (LVSD) in the elderly. METHODS: A total of 260 high-risk persons aged 75 years and older with and without heart disease participated. SE (GE Vingmed 7/E9) and HE (GE Vscan) were performed in all 260 persons by separate, blinded and experienced echocardiographers who followed guidelines from the Danish Society of Cardiology and completed a structured data sheet. Another blinded echocardiographer revised HE (HR) and SE twice (SR). Data were analysed using STRATA and Cohen's Kappa statistic, and intra- and inter-observer variations and predictive values were calculated. RESULTS: Comparison of HR and SR, and HE and SE showed modest intra- and interobserver variation and good agreement in diagnosing LVSD and other changes in cardiac function and morphology (significant valvular disease), corresponding to a low inter-method variation and a good safety; thus, HE can be used to screen for LVSD and other cardiac abnormalities. Besides, the negative predictive values were high; thus, HE can be relied upon to omit persons with normal echoes from referral to SE. CONCLUSION: According to this study, HE is a valuable tool to screen for LVSD and other changes in cardiac function and morphology in a high-risk population aged 75+ years; nothing very important is missed by HE and the experienced echocardiographers; and in case of a normal HE, it is safe not to refer to SE. FUNDING: Puljen til Tvaersektorielle Projekter (Research fund of cross-sectional health-projects), TrygFonden (Danish foundation TrygFonden) and Den Regionale Forskningsfond (Region Zealand Health Scientific Research Foundation). TRIAL REGISTRATION: not relevant.
