2 research outputs found
Clinical utility and cost effectiveness of a personal ultrasound imager for cardiac evaluation during consultation rounds in patients with suspected cardiac disease
OBJECTIVE: To assess the clinical utility and cost effectiveness of a
personal ultrasound imager (PUI) during consultation rounds for cardiac
evaluation of patients with suspected cardiac disease. METHODS: 107
unselected patients from non-cardiac departments (55% men) were enrolled
in the study. After the physical examination the consultant cardiologist
performed an echocardiographic study with a PUI. The final report was
given instantly to the referring physician. All patients subsequently
underwent a study with a standard echocardiographic device (SED). For each
patient the consultant cardiologist noted whether the findings of the PUI
were adequate for final diagnosis. The total cost when full
echocardiography was used was compared with the cost when the PUI was
used. The time interval from request to diagnosis was also compared.
RESULTS: In 84 (78.5%) patients no further examination with an SED was
regarded as necessary. Twenty three patients (21.5%) required a further
detailed examination with the SED because of the need for haemodynamic
information. There was an excellent agreement for the detection of
abnormalities between the two devices (96%). The total cost was euro;132
per patient with the SED and euro;75 per patient with the PUI. According
to this study, the use of the PUI can lead to a 33.4% reduction of total
cost. The mean time from request to diagnosis at the authors' institutio
Left ventricular hypertrophy screening using a hand-held ultrasound device
AIMS: To test the diagnostic potential of a hand-held ultrasound device
for screening for left ventricular hypertrophy in a hypertensive
population using a standard echocardiographic system as a reference.
METHODS: One hundred consecutive hypertensive patients were enrolled. An
experienced investigator performed measurements of the thickness of the
anterior septum and posterior wall using the parasternal 2D-long axis view
and the end-diastolic dimension of the left ventricle with both imaging
devices. Left ventricular hypertrophy was defined as an increase in left
ventricular mass > or = 134 g x m(-2) for men and > or = 110 g x m(-2) for
women, when indexed for body surface area and > or = 143 g x m(-1) for men
and > or = 102 g x m(-1) for women, when indexed for height. RESULTS:
Sixty-five men and 35 women were studied (age 60 +/- 11 years); mean
duration of hypertension: 13 +/- 11 years; mean blood pressures: systolic
150 +/- 20 mmHg and diastolic 89 +/- 11 mmHg. The anterior septum and
posterior wall were visualized in all patients with both imaging devices.
The standard echocardiographic system identified left ventricular
hypertrophy by body surface area in 18 (18%) patients and by height in 26
(26%) patients. The agreement between the standard echocardiographic
system and the hand-held device for the assessment of left ventricular
hypertrophy was 93%, kappa: 0.77 (left ventricular mass/body surface area)
and 90%, kappa: 0.76 (left ventricular mass/height). CONCLUSIONS: We
conclude that hand-held devices can be effectively applied for screening
for left ventricular hypertrophy in hypertensive patients