Reliability of cardiac dimensions and valvular regurgitation assessment by sonographers using hand-carried ultrasound devices

• Published in: European journal of echocardiography Vol. 7; no. 4; pp. 275 - 283
• Main Authors: Coletta, Claudio, De Marchis, Elettra, Lenoli, Monica, Rosato, Stefano, Renzi, Marco, Sestili, Augusto, Romano, Patrizia, Infusino, Tommaso, Ricci, Roberto, Ceci, Vincenzo
• Format: Journal Article
• Language: English
• Published: England 01.08.2006
• Subjects: Aorta - diagnostic imaging; Aorta - pathology; Echocardiography - instrumentation; Echocardiography - methods; Feasibility Studies; Female; Heart Atria - diagnostic imaging; Heart Atria - pathology; Humans; Male; Middle Aged; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - pathology; Reproducibility of Results
• ISSN: 1525-2167; 1532-2114
• DOI: 10.1016/j.euje.2005.06.003

We sought to assess the reliability of some basic echocardiographic data obtained by trained sonographers using a hand-held ultrasound device. One hundred and twelve consecutive patients (mean age 61, 64 males) referred for in-hospital or ambulatory routine echocardiography were considered. All patients underwent two-dimensional and colour Doppler examination performed by a trained sonographer equipped with a hand-held ultrasound device and by a certified cardiologist equipped with a standard platform, in random order. Indexed left ventricular end-diastolic and end-systolic transverse diameters, aortic root, end-systolic left atrium transverse diameter, end-diastolic interventricular septum and posterior wall thickness were calculated by two-dimensional left parasternal long-axis view in blind conditions. Mitral and aortic valve regurgitation were investigated by colour-Doppler imaging on parasternal and apical views and compared using a 0 to 4 semi-quantitative score. Overall feasibility was high for both settings (sonographers: 93%; cardiologists: 95%; P not significant). Excellent concordance of end-diastolic diameter (kappa 0.75), left atrium (kappa 0.76) and interventricular septum thickness (kappa 0.77) results was found. Good concordance was observed for end-systolic diameter (kappa 0.66), aortic root (kappa 0.64) and posterior wall thickness (kappa 0.67) results. A high linear correlation between the couples of results was present for all parameters. A good agreement of the mitral (kappa 0.66) and aortic (kappa 0.84) regurgitation scores was also found, with a low prevalence of discordant results (mitral regurgitation: 22%, aortic regurgitation: 9%) and no > or =2-point discrepancies. In a general population referred for Doppler echocardiography, basic cardiac linear dimensions and valvular regurgitation severity assessment by trained sonographers using hand-held ultrasound devices appear accurate and reliable for routine clinical use.