title: A novel and simple method using pocket-sized echocardiography to screen for aortic stenosis.
abstract: BACKGROUND
  Pocket-sized echocardiography may serve as an initial tool to screen for aortic stenosis (AS). The purpose of this study was to evaluate the usefulness of a novel and simple method using pocket-sized echocardiography to screen for AS.
  
  
  METHODS
  Subjects (n= 130) with systolic ejection murmur or known AS were studied. After physical examination, each aortic cusp's opening was visually scored using pocket-sized echocardiography as follows: 0= not restricted, 1= restricted, or 2= severely restricted. The sum of the scores was defined as the visual AS score. On the basis of high-end echocardiography, an aortic valve area index <0.60 cm(2)/m(2) and an aortic valve area index of 0.60 to 0.85 cm(2)/m(2) were considered to indicate severe and moderate AS, respectively.
  
  
  RESULTS
  For diagnosing severe AS (n= 27), a visual AS score ≥ 4 had sensitivity of 85% and specificity of 89%. For diagnosing moderate to severe AS (n= 57), a visual AS score ≥ 3 had sensitivity of 84% and specificity of 90%. The areas under the receiver operating characteristic curves for diagnosing severe and moderate to severe AS with a visual AS score (0.946 and 0.936, respectively) were slightly larger than those for a skilled physical examination (0.917 and 0.898, respectively) (P= NS for both) but were significantly larger than for an aortic valve calcification score also obtained using pocket-sized echocardiography (areas under the curve, 0.816 [P= .0015] and 0.827 [P= .0001], respectively).
  
  
  CONCLUSIONS
  A novel and simple method using pocket-sized echocardiography is useful for rapid grading of AS in subjects with systolic ejection murmur.
authors.affiliation: Department of Cardiology, Osaka City General Hospital, Osaka, Japan. abeyukio@aol.com
authors.forename: Yukio
authors.initials: Y
authors.lastname: Abe
authors.forename: Makoto
authors.initials: M
authors.lastname: Ito
authors.forename: Chiharu
authors.initials: C
authors.lastname: Tanaka
authors.forename: Kazato
authors.initials: K
authors.lastname: Ito
authors.forename: Takahiko
authors.initials: T
authors.lastname: Naruko
authors.forename: Akira
authors.initials: A
authors.lastname: Itoh
authors.forename: Kazuo
authors.initials: K
authors.lastname: Haze
authors.forename: Takashi
authors.initials: T
authors.lastname: Muro
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshiyama
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019540:Area Under Curve; D004452:Echocardiography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D010808:Physical Examination; D019095:Point-of-Care Systems; D012372:ROC Curve; D012680:Sensitivity and Specificity