[Hand-held echocardiographic devices: what do they add to the initial cardiovascular evaluation?].
OBJECTIVE
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.


METHODS
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.
Martín-Peñato
Arturo
A
Servicio de Cardiología. Hospital Universitario de Getafe. Getafe. Madrid. Spain.
Zamorano
José L
JL
Almería
Carlos
C
Rodrigo
José L
JL
Corros
Cecilia
C
Luaces
María
M
Conde
Antonio
A
Vilacosta
Isidro
I
Macaya
Carlos
C
D000368:Aged; D002318:Cardiovascular Diseases / Q000175:diagnosis*; D018618:Echocardiography, Doppler, Color / Q000295:instrumentation* / Q000379:methods; D004864:Equipment and Supplies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male