Clinical InvestigationEchocardiography at the “Point of Care”Diagnostic Accuracy of a Hand-Held Ultrasound Scanner in Routine Patients Referred for Echocardiography
Section snippets
Study Population and Echocardiographic Protocol
During a 5-week period, 349 unselected consecutive routine patients from the echocardiography lab at University Hospital Gasthuisberg (Leuven, Belgium) were scanned with a HAND scanner (Vscan; GE Vingmed Ultrasound AS, Horten, Norway; Figures 1A and 1B) and modern HIGH scanners, such as Vivid 7 or E9 (GE Vingmed Ultrasound AS) as the gold standard (using the M3S probe [GE Vingmed Ultrasound AS] at 1.5–4.0 MHz). Harmonic imaging was used in HIGH scanners by default. The examinations with HAND
Patient Population
We examined 349 consecutive routine patients (196 men). The mean age was 61.5 ± 15.0 years (range, 20.0–89.0 years). The patients had a mean body mass index of 25.8 ± 4.7 kg/m2 (range, 15.0–48.0 kg/m2). The LV EF ranged from 20% to 70% (mean, 55.6 ± 10.0%).
Use of the HAND Device
Operating the device was easy and intuitive. Basic functions were found quickly by trial and error. After reading an A4-size instruction card, all functions could be controlled without problems. Lifting the screen switches the device on and
Discussion
The introduction of HAND scanners has raised several questions. It is particularly interesting whether their image quality is sufficient for clinical decision making in daily clinical practice, considering that earlier studies reported drawbacks of older portable ultrasound devices in a cardiology outpatient clinic,6 in cardiology consultations in a hospital setting,7 in the screening of special patient subsets,8 or in small unselected populations of a tertiary cardiac center.8, 9, 10, 11 The
Conclusions
Echocardiography with handheld scanner was feasible in routine clinical practice. No clinically relevant findings were missed. Only spectral Doppler features are missing to make examinations complete and clinically valid. Apart from that, high-end scanning demonstrated advantages in image quality only in difficult-to-scan patients.
Given the future implementation of full standard echocardiographic functionality, this new class of device has the potential to be safely used by experienced
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