Abstract 18734: First Validation of a Pocket, Miniature, High-Resolution Echocardiographic Device: The First Real Stethoscope?
Introduction: A new miniature high-resolution pocket-mobile echocardiographic (PME) device has become available to clinicians, but there are no data available comparing this technology with standard transthoracic echo (TTE) examination.
Hypothesis: PME images obtained during a quick screening exam (as might be used to augment physical exam) correlate well with standard TTE.
Methods: We attempted to acquire seven standard echocardiography views with the PME in five minutes or less immediately prior to completing a comprehensive standard TTE on 97 consecutive unselected patients. Images from the two modalities were compared with regard to ejection fraction (EF), segmental wall motion abnormalities (WMA), left ventricular end-diastolic dimension (LVEDD), inferior vena cava (IVC) size, aortic and mitral valve pathology, and pericardial effusion by two experienced echocardiographers and two cardiology fellows. The PME images were reviewed blind to the TTE Results.
Results: Patients had a mean age 68 years, 45% were male, 13.5% had EF < 45%, 12.5% had WMA, 15.5% had an enlarged LVEDD (women > 5.3 cm, men > 5.9 cm), 11.6% had a dilated IVC (RAP ≥ 10 mmHg), 7.2% had a structurally abnormal mitral valve, 6.2% had aortic stenosis (AS), and there were no significant pericardial effusions. Fifty-nine percent of PME exams were completed in less than five minutes (mean 4.7, range 2.4 - 8.9), and the images were adequate for interpretation of EF in 95.4% of studies, LVEDD 94.6%, mitral valve 89.9%, WMA 83.3%, aortic valve 82.7%, and IVC 75%. Compared to standard TTE, PME interpretation by attendings and fellows had an accuracy of 97.2% and 93.2% for EF, respectively. Likewise, accuracy for WMA was 89.8% and 87.1%; LVEDD 94.1% and 90.7%; AS 96.5% and 94.8%; mitral abnormality 87.9% and 82.2%; and IVC size 81.2% and 74.1%.
Conclusion: PME provides excellent visualization in the vast majority of patients and correlates exceptionally well with standard TTE with regard to EF, WMA, LVEDD, AS, mitral valve abnormalities, and to a somewhat lesser degree with IVC size. In this way PME appears to be a viable, efficient and potentially cost-effective point-of-care screening tool that can be used in virtually any medical setting including routine physical exam to serve as a true “stethoscope.”
- © 2010 by American Heart Association, Inc.