青年运动员中的肥厚型心肌病：医学生通过即时超声心动图进行成功筛查。
Hypertrophic Cardiomyopathy in Youth Athletes: Successful Screening With Point-of-Care Ultrasound by Medical Students.
作者信息
Fox J Christian, Lahham Shadi, Maldonado Graciela, Klaus Suzi, Aish Bassil, Sylwanowicz Lauren V, Yanuck Justin, Wilson Sean P, Shieh Mason, Anderson Craig L, English Carter, Mayer Ryan, Mohan Uthara R
机构信息
Department of Emergency Medicine, University of California Irvine Health, Orange, California, USA.
University of California Irvine, School of Medicine, Irvine, California, USA.
出版信息
J Ultrasound Med. 2017 Jun;36(6):1109-1115. doi: 10.7863/ultra.16.06044. Epub 2017 Mar 4.
OBJECTIVES
Hypertrophic cardiomyopathy (HCM) is a life-threatening genetic cardiovascular disease that often goes undetected in young athletes. Neither history nor physical examination are reliable to identify those at risk. The objective of this study is to determine whether minimally trained medical student volunteers can use ultrasound to screen for HCM.
METHODS
This was a prospective enrollment of young athletes performed at 12 area high schools and three area colleges, between May 2012 and August 2013. All participants underwent point-of-care ultrasound performed screening for HCM by trained medical students and reviewed by a pediatric cardiologist. An interventricular septum to left ventricular posterior wall ratio greater than 1.25 was considered to be abnormal (positive screen).
RESULTS
A total of 2332 participants were enrolled. There were 137 (5.8%) with a positive screening for HCM, of which 7 (5.1%) were confirmed to have HCM by a pediatric cardiologist. In a small cohort with positive screen for HCM, there was a 100% sensitivity (95% confidence interval, 59.04 to 100%) and 4.86% (95% confidence interval, 1.98 to 9.76%) positive predictive value of for having HCM.
CONCLUSIONS
Volunteer medical students, using point-of-care ultrasound, were able to effectively screen for HCM in young athletes.
目的
肥厚型心肌病（HCM）是一种危及生命的遗传性心血管疾病，在年轻运动员中常常未被发现。病史和体格检查都无法可靠地识别出有风险的人群。本研究的目的是确定经过最低限度培训的医学生志愿者是否可以使用超声来筛查HCM。
方法
这是一项于2012年5月至2013年8月在12所地区高中和3所地区大学对年轻运动员进行的前瞻性研究。所有参与者均接受了由经过培训的医学生进行的即时超声心动图HCM筛查，并由一名儿科心脏病专家进行复查。室间隔与左心室后壁比值大于1.25被认为异常（筛查阳性）。
结果
共招募了2332名参与者。有137人（5.8%）HCM筛查呈阳性，其中7人（5.1%）经儿科心脏病专家确诊患有HCM。在一小群HCM筛查呈阳性的人群中，HCM的敏感性为100%（95%置信区间，59.04至100%），阳性预测值为4.86%（95%置信区间，1.98至9.76%）。
结论
使用即时超声心动图的医学生志愿者能够有效地对年轻运动员进行HCM筛查。
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