Balouch Iram J, Qamar Nadeem, Baqai Lubna, Naz Mariam, Gurmani Sumyia, Karim Musa
Echocardiography, National Institute of Cardiovascular Diseases, Hyderabad, PAK.
Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK.
Cureus. 2019 Sep 23;11(9):e5735. doi: 10.7759/cureus.5735.
Introduction Transthoracic echocardiography (TTE) is the primary noninvasive imaging modality for quantitative and qualitative evaluation of cardiac anatomy and function. The Hyderabad satellite center of National Institute of Cardiovascular Diseases (NICVD), Pakistan has recently started its operations, including TTE; therefore, it is imperative to assess the initial experience for the process improvement of the center. Therefore, the aim of this clinical audit was to review our initial experience of TTE at this newly operational satellite center. Methods In this clinical audit, we reviewed the records of patient undergone TTE at the echocardiography department of NICVD Hyderabad satellite center from May 2018 to October 2018. Demographic characteristics, clinical history, indications for the TTE, and echocardiographic diagnoses were reviewed. Results A total of 2,177 TTE procedures were performed during the study period of six months out of which 68.7% (1,496) were performed in male patients. Mean age of the patients was 50.83 ± 12.44 years with 48.2% (1,050) patients above 50 years of age. The most frequent indication for the procedure was cardiomyopathy, 54.1% (1,177), among other indications, native valve regurgitation was in 49.8% (1,085), ischemic heart disease in 23.2% (504), heart murmurs in 17.3% (377), cardiac masses in 14.3% (312), pericardial disease in 8.5% (184), pulmonary disease in 7.3% (160), infective endocarditis in 6.4% (139), aortic and major disease in 6.3% (138), and native valve stenosis in 5.4% (177) of the patients. Procedures were performed before coronary artery revascularization in 2.2% (47) and for prosthetic valve assessment in 1.7% (38) patients. The TTE was normal in 36.6% (796) patients, while the most frequent diagnosis was cardiomyopathy, 53.8% (1,172), among the other TTE findings valvular heart disease was in 21.8% (475), ischemic heart disease (IHD) in 21.6% (470), pericardial disease in 8.0% (175), and congenital heart disease (CHD) in 1.4% (30) patients. Conclusion This clinical audit showed the effective use of TTE as a noninvasive imaging modality for quantitative and qualitative evaluation of cardiac anatomy and function at a newly operational satellite center of a resource-limited country with normal TTE findings in only 36.6% of the patients.
引言
经胸超声心动图（TTE）是用于心脏解剖结构和功能定量与定性评估的主要无创成像方式。巴基斯坦国家心血管疾病研究所（NICVD）的海得拉巴卫星中心最近开始运营，包括开展TTE检查；因此，评估该中心的初始经验对于其流程改进至关重要。所以，本次临床审计的目的是回顾我们在这个新运营的卫星中心进行TTE检查的初始经验。
方法
在本次临床审计中，我们回顾了2018年5月至2018年10月在NICVD海得拉巴卫星中心超声心动图科接受TTE检查的患者记录。对人口统计学特征、临床病史、TTE检查的适应证以及超声心动图诊断进行了回顾。
结果
在为期6个月的研究期间共进行了2177例TTE检查，其中68.7%（1496例）在男性患者中进行。患者的平均年龄为50.83±12.44岁，48.2%（1050例）患者年龄在50岁以上。该检查最常见的适应证是心肌病，占54.1%（1177例），其他适应证包括：原发性瓣膜反流占49.8%（1085例），缺血性心脏病占23.2%（504例），心脏杂音占17.3%（377例），心脏肿物占14.3%（312例），心包疾病占8.5%（184例），肺部疾病占7.3%（160例），感染性心内膜炎占6.4%（139例），主动脉及主要疾病占6.3%（138例），原发性瓣膜狭窄占5.4%（177例）。2.2%（47例）患者在冠状动脉血运重建术前进行了检查，1.7%（38例）患者进行了人工瓣膜评估。36.6%（796例）患者的TTE检查结果正常，而最常见的诊断是心肌病，占53.8%（1172例），其他TTE检查结果包括：瓣膜性心脏病占21.8%（475例），缺血性心脏病（IHD）占21.6%（470例），心包疾病占8.0%（175例），先天性心脏病（CHD）占1.4%（30例）。
结论
本次临床审计表明，在一个资源有限国家的新运营卫星中心，TTE作为一种无创成像方式有效地用于心脏解剖结构和功能的定量与定性评估，仅36.6%的患者TTE检查结果正常。
