Reliability of cardiac dimensions and valvular regurgitation assessment by sonographers using hand-carried ultrasound devices.
OBJECTIVE
We sought to assess the reliability of some basic echocardiographic data obtained by trained sonographers using a hand-held ultrasound device.


METHODS
One hundred and twelve consecutive patients (mean age 61, 64 males) referred for in-hospital or ambulatory routine echocardiography were considered. All patients underwent two-dimensional and colour Doppler examination performed by a trained sonographer equipped with a hand-held ultrasound device and by a certified cardiologist equipped with a standard platform, in random order. Indexed left ventricular end-diastolic and end-systolic transverse diameters, aortic root, end-systolic left atrium transverse diameter, end-diastolic interventricular septum and posterior wall thickness were calculated by two-dimensional left parasternal long-axis view in blind conditions. Mitral and aortic valve regurgitation were investigated by colour-Doppler imaging on parasternal and apical views and compared using a 0 to 4 semi-quantitative score.


RESULTS
Overall feasibility was high for both settings (sonographers: 93%; cardiologists: 95%; P not significant). Excellent concordance of end-diastolic diameter (kappa 0.75), left atrium (kappa 0.76) and interventricular septum thickness (kappa 0.77) results was found. Good concordance was observed for end-systolic diameter (kappa 0.66), aortic root (kappa 0.64) and posterior wall thickness (kappa 0.67) results. A high linear correlation between the couples of results was present for all parameters. A good agreement of the mitral (kappa 0.66) and aortic (kappa 0.84) regurgitation scores was also found, with a low prevalence of discordant results (mitral regurgitation: 22%, aortic regurgitation: 9%) and no > or =2-point discrepancies.


CONCLUSIONS
In a general population referred for Doppler echocardiography, basic cardiac linear dimensions and valvular regurgitation severity assessment by trained sonographers using hand-held ultrasound devices appear accurate and reliable for routine clinical use.
Coletta
Claudio
C
Cardiology Department, S. Spirito Hospital, Rome, Italy. claudiocoletta@interfree.it
De Marchis
Elettra
E
Lenoli
Monica
M
Rosato
Stefano
S
Renzi
Marco
M
Sestili
Augusto
A
Romano
Patrizia
P
Infusino
Tommaso
T
Ricci
Roberto
R
Ceci
Vincenzo
V
D001011:Aorta / Q000000981:diagnostic imaging / Q000473:pathology; D004452:Echocardiography / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results