title: Community screening for left ventricular hypertrophy in patients with hypertension using hand-held echocardiography.
abstract: Left ventricular (LV) hypertrophy (LVH) confers increased cardiovascular risk on patients with hypertension. Echocardiography using new hand-held devices might allow community-based cost-effective screening for LVH in a targeted hypertensive population. Thus, the aim of this study was to test the validity of hand-held ultrasound devices to screen for LVH in the community. Accordingly, 189 patients with hypertension attending a community-based heart failure screening program underwent echocardiography by both hand-held and standard devices by an experienced echocardiographer. LVH was defined as LV mass index >/=134 g.m(-2) for men and >/=110 g.m(-2) for women using the Devereux-modified American Society of Echocardiography cube equation. No significant differences were noted between the 2 devices in the measurement of LV wall thickness or LV mass index. Agreement for estimation of LVH between the 2 devices was 86% (kappa = 0.63). The sensitivity, specificity, and positive and negative predictive values of the hand-held device for predicting LVH were 72%, 91%, 73%, and 90%, respectively. Thus, hand-held echocardiography devices accurately assessed LVH and may be used for community-based screening for LVH in targeted patients with hypertension.
authors.affiliation: Department of Cardiovascular Medicine, Northwick Park Hospital, Watford Rd, Harrow, Middlesex, HAI 3UJ United Kingdom. roxy.senior@virgin.net
authors.forename: Roxy
authors.initials: R
authors.lastname: Senior
authors.forename: Gavin
authors.initials: G
authors.lastname: Galasko
authors.forename: Michael
authors.initials: M
authors.lastname: Hickman
authors.forename: Paramjit
authors.initials: P
authors.lastname: Jeetley
authors.forename: Avijit
authors.initials: A
authors.lastname: Lahiri
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D015331:Cohort Studies; D003153:Community Health Services; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015588:Observer Variation; D019095:Point-of-Care Systems; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D013318:Stroke Volume / Q000502:physiology; D013599:Systole / Q000502:physiology; D006113:United Kingdom / Q000453:epidemiology