Hand-Carried Echocardiography in Heart Failure and Heart Failure Risk Population: A Community Based Prospective Study

Abstract

The basic reservation concerning the use of hand-carried echocardiographic devices by general practitioners has been a lack of data demonstrating that they would provide clinically important information on patients' outcomes. One hundred seventy-five patients with heart failure and/or heart failure risk factors were selected from a general community outpatient clinic. They underwent simplified hand-carried echocardiography performed by an internist with basic echocardiographic experience and N-terminal pro-B-type natriuretic peptide measurements. Patients were followed for the occurrence of the combined end point, consisting of death or hospitalization for cardiovascular causes. Hand-carried echocardiographic results were abnormal in 90 patients (55%). During 48 ± 7 months of follow-up, the combined end point occurred in 41 patients (25%). On multivariate analysis, only abnormal echocardiography (hazard ratio, 5.55; 95% confidence interval, 2.04-14.28; P = .0004) was an independent predictor of outcomes. Hand-carried echocardiographic examinations performed by an internist with basic echocardiographic training can provide important prognostic information, independent of N-terminal pro-B-type natriuretic peptide levels.