title: Portable spectral Doppler echocardiographic device: overcoming limitations.
abstract: BACKGROUND
  There is evidence that new portable echocardiographic devices are useful in evaluating heart anatomy and function, but a lack of Doppler modes has up to now been an important limitation in obtaining haemodynamic data.
  
  
  OBJECTIVE
  To report the Doppler capabilities of a new hand held echocardiographic device.
  
  
  METHODS
  Blinded comparison of two types of echocardiography machine.
  
  
  METHODS
  Tertiary care centre.
  
  
  METHODS
  98 consecutive patients were randomly imaged with the hand held device, with a standard platform as reference.
  
  
  METHODS
  Pulsed wave transmitral Doppler inflow tract velocities, deceleration time, and continuous wave Doppler measurements of aortic ejection and tricuspid regurgitation peak velocities were recorded.
  
  
  RESULTS
  There was excellent agreement between the hand held device and standard echocardiography for the evaluation of diastolic E and A waves, E/A ratio, and deceleration time with pulsed wave Doppler (intraclass correlation coefficients of 0.97, 0.93, 0.90, and 0.78, respectively). In addition, good agreement was found between continuous wave Doppler measurements of aortic ejection and tricuspid regurgitation velocities (intraclass correlation coefficients of 0.96 and 0.80). However, there was a significant difference between patients with tricuspid regurgitation measured with the hand held device (25.5%) and by standard echocardiography (65.3%), resulting in misdiagnosis of eight patients with pronounced pulmonary hypertension.
  
  
  CONCLUSIONS
  New hand held devices with Doppler capabilities overcome previous limitations in evaluating haemodynamic variables. With colour Doppler they are now suitable for the complete evaluation of valvar disease and diastolic function. However, important limitations remain in the evaluation of pulmonary pressures.
authors.affiliation: Non-invasive Cardiology Laboratory, Hospital Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Quiles
authors.forename: M A
authors.initials: MA
authors.lastname: García-Fernández
authors.forename: P B
authors.initials: PB
authors.lastname: Almeida
authors.forename: E
authors.initials: E
authors.lastname: Pérez-David
authors.forename: J
authors.initials: J
authors.lastname: Bermejo
authors.forename: M
authors.initials: M
authors.lastname: Moreno
authors.forename: P
authors.initials: P
authors.lastname: Avanzas
mesh_terms: D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology; D001783:Blood Flow Velocity / Q000502:physiology; D015150:Echocardiography, Doppler / Q000295:instrumentation* / Q000592:standards; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000503:physiopathology