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Pocket-sized echocardiography for screening structural heart disease: diagnostic accuracy and cost-effectiveness for population-based studies

Published online by Cambridge University Press:  09 January 2020

Avisa Tabib ,
Niloufar Samiei ,
Mohammad M. Peighambari ,
Fariba Rashidi Ghader ,
Maryam Moradian ,
Ahmad Mohebbi ,
Gholamreza Omrani ,
Alireza A. Ghavidel ,
Bahareh Kazemborji  and
Feridoun Noohi
...Show all authors
Avisa Tabib
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Niloufar Samiei*
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Mohammad M. Peighambari
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Fariba Rashidi Ghader
Affiliation:
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Maryam Moradian
Affiliation:
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Ahmad Mohebbi
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Gholamreza Omrani
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Alireza A. Ghavidel
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Bahareh Kazemborji
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Feridoun Noohi
Affiliation:
Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Majid Maleki
Affiliation:
Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Yousef Rezaei
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Saeid Hosseini
Affiliation:
Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
*
Author for correspondence: N. Samiei, Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-e-Asr Avenue, Tehran 1995614331, Iran. Tel: +98 212 3923061; Fax: +98 212 2663209; E-mail: drnsamiei@gmail.com
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Abstract

Background:

The standard transthoracic echocardiography has some limitations in emergent and community-based situations. The emergence of pocket-sized ultrasound has led to influential advancements.

Methods:

In this prospective study, in the hospital-based phase, children with suspected structural heart diseases were enrolled. In the school-based phase, healthy children were randomly selected from six schools. All individuals were examined by experienced operators using both the standard and the pocket-sized echocardiography.

Results:

A total of 73 individuals with a mean age of 9.9 ± 3.2 years in the hospital-based cohort and 143 individuals with a mean age of 12.8 ± 2.9 years in the school-based cohort were examined. The agreements between the standard and the pocket-sized echocardiography were good or excellent for major CHDs in both cohorts (κ statistics > 0.61). Among valvular pathologies, agreements for tricuspid and pulmonary valves’ regurgitation were moderate among school-based cohorts (0.56 [95% confidence interval 0.12–1] and 0.6 [95% confidence interval 0.28–0.91], respectively). The agreements for tricuspid and pulmonary valves’ regurgitation were excellent (>0.9) among hospital-based population. Other values for valvular findings were good or excellent. The overall sensitivity and specificity were 87.5% (95% confidence interval 47.3–99.7) and 93.8% (95% confidence interval 85–98.3) among the hospital-based individuals, respectively, and those were 88% (95% confidence interval 77.8–94.7) and 68.4% (95% confidence interval 56.7–78.6) among the school-based individuals, respectively. The cost of examination was reduced by approximately 70% for an individual using the pocket-sized device.

Conclusions:

When interpreted by experienced operators, the pocket-sized echocardiography can be used as screening tool among school-aged population.

Keywords

Structural heart diseaseechocardiographypocket-sized ultrasound devicechildrenpopulation-based study
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 2 , February 2020 , pp. 197 - 204
Copyright
© Cambridge University Press 2020

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Footnotes

Authors’ note: SHED LIGHT study (Structural HEart Disease in pupiLs by echocardIoGrapHic Test) is a population-based investigation to detect the burden of structural heart diseases among children in the urban areas of Tehran, Iran, by the implementation of echocardiographic examinations.

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