Hand-held miniaturized cardiac ultrasound instruments for rapid and effective bedside diagnosis and patient screening.
OBJECTIVE
Technological progress in recent years has made it possible that ultrasound industry can now offer affordable, portable and battery-operated ultrasound systems the size of a laptop computer. The purpose of this study was to compare these hand-carried ultrasound instruments with standard echocardiography in order to investigate the facility of a rapid bedside diagnosis in patients with suspected or known cardiovascular disease.


METHODS
Fifty consecutive patients were studied with miniaturized ultrasound equipment (SonoHeart) and a conventional scanner (Acuson Sequoia) in a blinded manner. All studies were performed by three board-certified cardiologists skilled and experienced in echocardiographic practice. Investigators were not aware of any previous medical reports.


RESULTS
With the new system, adequate images could be obtained in all patients. Left ventricular and left atrial diameters measured with the hand-held system correlated well with those obtained with conventional scanning: r = 0.87, mean difference 3.12 +/- 2.7 mm and r = 0.84, mean difference 2.8 + 2.4 mm, respectively. The presence of left ventricular dysfunction, regional wall motion abnormalities, relevant valvular regurgitation (moderate or more) or valve stenosis was correctly diagnosed in all patients. However, there was a tendency towards underestimating the extent of wall motion abnormalities particularly in patients difficult to image. Discrepancies also frequently occurred in patients with trivial or mild regurgitation, where false-positive and false-negative findings were described.


CONCLUSIONS
Currently available hand-held echocardiography systems can facilitate rapid bedside diagnosis and patient screening. However, this recent development in echocardiography also raises a number of questions and its actual impact on general clinical practice still remains to be evaluated.
Scholten
Christine
C
Department of Cardiology, University of Vienna, Vienna, Austria. christine.scholten@univie.ac.at
Rosenhek
Raphael
R
Binder
Thomas
T
Zehetgruber
Manfred
M
Maurer
Gerald
G
Baumgartner
Helmut
H
D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000295:instrumentation; D015150:Echocardiography, Doppler / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D013673:Technology Assessment, Biomedical