Screening of valvular heart disease using pocket-sized transthoracic echocardiography device

Abstract

Valvular heart disease (VHD) is an increased common problem in clinical practice. Early diagnosis of significant VHD is a real challenge, allowing to propose an appropriate follow-up and the best therapeutic strategy. Standard transthoracic echocardiography (sTTE) is the gold standard for the detection of VHD. Pocket-sized transthoracic echocardiography (pTTE) is an incomplete sTTE and its usefulness for screening and evaluation of VHD is uncertain. The aim of this study was to evaluate the performance of pTTE compared to sTTE and auscultation for an early screening of VHD. sTTE, pTTE (Vscan; GE Healthcare) and auscultation were performed by three different physicians in 284 unselected consecutive patients. All VHD detected by each of these three techniques were noted. sTTE was the gold standard. Each physician was blinded to the result of the other exams. We diagnosed a total of 301 VHDs with a large predominance of regurgitant lesions: 269 (89.3%) regurgitant VHDs and 32 (10.7%) stenotic VHDs. pTTE was highly sensitive (85.7%) and specific (97.9%) for screening VHD while auscultation detected only 54.1%. All significant VHDs (at least mild severity) were detected by pTTE. All aortic and mitral regurgitations not detected by pTTE were trivial regurgitations and concerned patients with a poor echogenicity. pTTE is reliable for screening significant VHD and should be proposed as a new screening tool. ( Fig. 1 )