Diagnostic accuracy of new handheld echocardiography with Doppler and harmonic imaging properties.
BACKGROUND
The first generation of handheld echocardiography devices was evaluated with divergent results because of inherent technical limitations. New handheld devices with continuous/pulsed wave Doppler and tissue harmonic imaging were introduced recently. In this study, comparisons were drawn among standard echocardiography, invasively measured systolic pulmonary artery pressure, and these new devices.


OBJECTIVE
We sought to evaluate new handheld echocardiography and its diagnostic accuracy compared with standard echocardiography.


METHODS
Two consecutive echocardiographic examinations were performed by experienced and independent examiners using handheld and standard echocardiography. Systolic pulmonary artery pressure was measured by Swan-Ganz catheter.


RESULTS
In all, 177 (56.2%) patients had normal cardiac function; 138 (43.8%) had underlying cardiac pathology. Handheld echocardiography had an overall agreement of 94.8% and kappa of 0.89 to detect the main echocardiographic finding. Handheld echocardiography detected valve disease with an agreement of 96.7% and kappa of 0.93; global left ventricular function was assessed correctly in 85.6% of cases. Pericardial effusion was diagnosed with an agreement of 91.2%. Dyssynergy was found by handheld echocardiography with an agreement of 95.4% and kappa value of 0.88. Systolic pulmonary artery pressure measured by handheld echocardiography and Swan-Ganz catheter had a correlation of 0.97.


CONCLUSIONS
This study demonstrates the high diagnostic accuracy of handheld devices with continuous/pulsed wave Doppler and harmonic imaging, and that these devices broaden the diagnostic spectrum while allowing for enhanced mobility in everyday clinical applications.
Medizinische Klinik met Schwerpunkt Kardiololgie, Angiologie, Charité Humboldt Universität zu Berlin, Schumannstrasse 20/21, 10098 Berlin, Germany. adrian.borges@charite.de
Adrian Constantin
AC
Borges
Fabian
F
Knebel
Torsten
T
Walde
Wasiem
W
Sanad
Gert
G
Baumann
D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D006328:Cardiac Catheterization; D034201:Computers, Handheld; D018618:Echocardiography, Doppler, Color; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D015588:Observer Variation; D011669:Pulmonary Wedge Pressure / Q000502:physiology; D013223:Statistics as Topic; D013599:Systole / Q000502:physiology; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology; D016277:Ventricular Function, Left / Q000502:physiology