Gulič Tatjana Golob, Makuc Jana, Prosen Gregor, Dinevski Dejan
Department of Cardiosurgery, University Clinical Center Maribor, Ljubljanska 5, 2000, Maribor, Slovenia.
Department of Internal Medicine, General Hospital Slovenj Gradec, Slovenj Gradec, Slovenia.
Wien Klin Wochenschr. 2016 May;128(9-10):348-53. doi: 10.1007/s00508-015-0904-6. Epub 2015 Dec 10.
The aim of this study was to assess the usefulness of a pocket-size imaging device in the hands of a noncardiologist as a screening tool for diagnosing aortic stenosis in individuals with newly discovered systolic murmur.
A total of 200 consecutive patients with systolic murmur were included; a limited focused cardiac ultrasound was performed with a pocket-size imaging device and compared to standard echocardiography. It was performed by a noncardiologist with no formal training in echocardiography. In all, 150 patients had morphological changes on the aortic valve, 77 had more than mild aortic stenosis, 30 had more than mild mitral regurgitation, 64 patients had more than moderate hypertrophy, 113 had more than moderately enlarged left atriums, and 3 had severely enlarged left ventricles. There were no significant difference in recognizing severe changes between Vscan focused cardiac ultrasound and comprehensive echocardiography.
Pocket-size ultrasound imaging devices without continuous and pulse wave Doppler modalities can, even in the hands of a noncardiologist with limited cardiac ultrasound instructions with high sensitivity and specificity, be a useful tool for detecting more than mild aortic stenosis and more than mild mitral regurgitation. As such a focused cardiac ultrasound can be an extension of physical examinations for patients with newly discovered systolic murmur.
本研究旨在评估一种便携式成像设备在非心脏病专家手中作为筛查工具对新发现收缩期杂音个体诊断主动脉瓣狭窄的有效性。
共纳入200例连续的收缩期杂音患者;使用便携式成像设备进行有限的心脏聚焦超声检查,并与标准超声心动图进行比较。检查由一名未接受过超声心动图正规培训的非心脏病专家进行。总计,150例患者主动脉瓣有形态学改变,77例有中重度以上主动脉瓣狭窄,30例有中重度以上二尖瓣反流,64例有中度以上肥厚,113例有中度以上左心房增大,3例有重度左心室增大。Vscan心脏聚焦超声与综合超声心动图在识别严重病变方面无显著差异。
即使在接受有限心脏超声指导的非心脏病专家手中,没有连续波和脉冲波多普勒模式的便携式超声成像设备也能以高灵敏度和特异性成为检测中重度以上主动脉瓣狭窄和中重度以上二尖瓣反流的有用工具。因此,这种心脏聚焦超声可作为新发现收缩期杂音患者体格检查的延伸。