The echocardiographers performed either standard or hand-held echocardiography blinded to any subject data and to each other´s results. The participants stayed in the same room during the procedure and were lying on an echocardiographic stretcher in a left-sided position. Within one hour, each participant underwent a standard echocardiography lasting approximately 15 minutes, and a hand-held echocardiography, which The 260 participants were invited to the outpatient clinic. Table 1 shows the baseline characteristics of the study participants. The subjects were recruited from the outpatient clinic and the general geriatric population with risk factors for or with known heart disease, as well as from the healthy background population. It included a total of 260 subjects aged 75 years old or older. The study population was representatives of a mixed and mobile geriatric population. For recruitment of patients, the study was announced locally in the Danish Association of Senior Citizens (Ældresagen), in a newspaper article, in our department of cardiology and in a heart failure clinic. It was performed in compliance with the Declaration of Helsinki and approved by the local ethics committee and the Danish Data Protection Agency. This study forms part of an investigation focusing on early detection of heart failure in the elderly population. The aim of the present study was to test the quality and usability of a hand-held echocardiograph compared with a standard echocardiograph for screening for LVSD in a geriatric population. They are inexpensive and easily accessible but only few investigations have compared them with standard echocardiographs. In recent years, portable echocardiographs have emerged on the market. Magnetic resonance has the best diagnostic reproducibility, but it is cumbersome as opposed to classic 2D echocardiography, which is the gold standard for LVSD diagnosis inĭaily clinical practice. The clinical diagnosis of LVSD is unreliable and cardiac dysfunction needs to be verified. Consequently, there is a need for reliable methods to screen for left ventricular systolic dysfunction (LVSD) in the growing geriatric population. Heart failure is common in the elderly, but there are indications of under-diagnosis and under-treatment. Besides, the negative predictive values were high thus, HE can be relied upon to omit persons with normal echoes from referral to SE.Ĭonclusion: 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.įunding: 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). 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. Data were analysed using STRATA and Cohen’s Kappa statistic, and intra- and inter-observer variations and predictive values were calculated. Another blinded echocardiographer revised HE (HR) and SE twice (SR). 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. Methods: A total of 260 high-risk persons aged 75 years and older with and without heart disease participated. 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.
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