title: Reliability of cardiac dimensions and valvular regurgitation assessment by sonographers using hand-carried ultrasound devices.
abstract: 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.
authors: Cardiology Department, S. Spirito Hospital, Rome, Italy. claudiocoletta@interfree.it
authors: Claudio
authors: C
authors: Coletta
authors: Elettra
authors: E
authors: De Marchis
authors: Monica
authors: M
authors: Lenoli
authors: Stefano
authors: S
authors: Rosato
authors: Marco
authors: M
authors: Renzi
authors: Augusto
authors: A
authors: Sestili
authors: Patrizia
authors: P
authors: Romano
authors: Tommaso
authors: T
authors: Infusino
authors: Roberto
authors: R
authors: Ricci
authors: Vincenzo
authors: V
authors: Ceci
mesh_terms: 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