Accuracy of Handheld Echocardiography for Bedside Diagnostic Evaluation in a Tertiary Cardiology Center: Comparison with Standard Echocardiography

Abstract

We aimed to assess the clinical role of a basic handheld echocardiographic device (HHE) used during cardiology training in evaluating different functional and morphological elements of the heart. 56 consecutive patients (pts), 26 women, mean age 60.0 ± 11.9 years admitted in our Cardiology Department had an echocardiogram performed by both cardiology trainees using a HHE with B-mode capabilities only and by cardiologists with advanced training in echocardiography using a standard echocardiography device (SE). Several parameters were analyzed: the presence of wall motion abnormalities (WMA), aortic valve abnormalities (AVAbn), mitral valve abnormalities (MVAbn), the presence of pericardial effusion (PE), as well as the presence of a dilated (LVD) or hypertrophied left ventricle (LVH). The Kappa coefficient of correlation between the two methods (k) was determined, along with the sensitivity (Sn), specificity (Sp), negative predictive value (NPV), and positive predictive value (PPV). Both HHE and SED examinations were possible in 52 of the 56 pts (92.8% feasibility). There was a moderate correlation in the assessment of WMA (k = 0.56) with a substantial agreement for MVAbn (k = 0.72), AVAbn (k = 0.76), LVH (k = 0.67) There was excellent agreement for LVD (k = 0.81). Valvular diseases were determined by HHE with good Sp (MVAbn - 97.4%, AVAbn - 100%), although the Sn and NPV were lower. Bedside evaluation using HHE is helpful for assessing LV chamber and walls dimensions, LV regional function, and morphological abnormalities of the valves. The device can be used by cardiology trainees with limited experience in echocardiography but only in combination with a standard examination.