title: Assessment of Primary Care Physicians' Use of a Pocket Ultrasound Device to Measure Left Ventricular Mass in Patients with Hypertension.
abstract: OBJECTIVE
  Left ventricular hypertrophy (LVH) is common in primary care and is associated with increased morbidity and mortality. Treatment of underlying hypertension can reverse LVH and eliminate the associated risks. Electrocardiography is widely available and commonly used to screen hypertensive patients for LVH, but it is limited by low sensitivity. Limited echocardiographic measurement of the left ventricle is a method for screening with improved sensitivity; however, it is not currently widely used in the primary care setting. This study attempts to test the accuracy of primary care physicians' (PCPs) measurements of the left ventricle using a pocket-sized ultrasound (pUS) device after a brief training session.
  
  
  METHODS
  This study was performed in an outpatient cardiology clinic by 3 family medicine residents and 1 family medicine faculty member after a 4-hour training session. Measurements of the left ventricle were made by PCPs using a pUS device; these measurements were compared with cardiologists' measurements from images obtained by echocardiography technicians. Left ventricular mass index (LVMI) was calculated based on these measurements and then compared between groups.
  
  
  RESULTS
  There was no statistically significant difference between the mean LVMI calculations in the 2 groups. The agreement in measurements between the groups, however, showed high variability. This was manifested by the low sensitivity (70%) and specificity (76%) of PCPs in the detection of LVH.
  
  
  CONCLUSIONS
  This study showed that limited echocardiography for the detection of LVH performed by PCPs at the point of care was feasible. Future studies are needed to determine the ideal training and experience necessary to yield competency.
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML). paul.bornemann@uscmed.sc.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Bornemann
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Jeremy
authors.initials: J
authors.lastname: Johnson
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Samuel
authors.initials: S
authors.lastname: Tiglao
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Amina
authors.initials: A
authors.lastname: Moghul
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Sheila
authors.initials: S
authors.lastname: Swain
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Gina
authors.initials: G
authors.lastname: Bornemann
authors.affiliation: From the Department of Family and Preventative Medicine, University of South Carolina, Columbia, SC (PB); the Department of Family Medicine, Tripler Army Medical Center, Honolulu, HI (JJ, ST, AM, SS, GB, ML).
authors.forename: Mike
authors.initials: M
authors.lastname: Lustik
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002309:Cardiology / Q000592:standards; D004452:Echocardiography / Q000295:instrumentation*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000067716:Point-of-Care Testing; D011320:Primary Health Care / Q000379:methods*
keywords: Left Ventricular Hypertrophy; Ultrasonography