1. Pocket-sized echo for evaluation of mitral and tricuspid regurgitation
- Author
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Junichi Yoshikawa, Kenei Shimada, Kenichiro Otsuka, Shota Fukuda, Hiromi Fujimoto, Tomoichiro Kubo, Yasushi Kono, Hiroshi Ito, Toshihiro Kawasaki, Minoru Yoshiyama, Satoshi Jissho, Kumiko Maeda, Haruyuki Taguchi, and Hiroki Oe
- Subjects
Male ,medicine.medical_specialty ,Regurgitation (circulation) ,Japan ,Left atrial ,Predictive Value of Tests ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Medical systems ,Aged ,Aged, 80 and over ,Mitral regurgitation ,Miniaturization ,business.industry ,Training level ,Ethics committee ,Mitral Valve Insufficiency ,Equipment Design ,Middle Aged ,Tricuspid Valve Insufficiency ,Echocardiography, Doppler, Color ,surgical procedures, operative ,Radiology Nuclear Medicine and imaging ,Predictive value of tests ,Sonographer ,cardiovascular system ,Linear Models ,Female ,Radiology ,business ,Cardiology and Cardiovascular Medicine - Abstract
Advances in electronic miniaturization and digital techniqueshave resulted in the advent of portable transthoracic echocar-diography (pTTE) imaging devices in the area of echocardiog-raphy. A pocket-sized pTTE imaging device that has colorDoppler imaging capability has been recently introduced intoclinical practice. This study aimed to examine the feasibilityand accuracy of the pocket-sized pTTE in the assessment ofthe severity of mitral regurgitation (MR) and tricuspid regur-gitation (TR).One hundred and eighty-six consecutive patients (ages 66 19 years; 107 male) underwent standard transthoracic echo-cardiography (sTTE) and pTTE. Initially, pTTE was per-formed by a well-trained sonographer for 121 patients. For thelater 65 patients, pTTE was examined by a less experiencedsonographer who had 6 months of experience in echocardiog-raphy, with the number of TTE examinations compatible withAmerican Society of Echocardiography training level 1 (1).These sonographers were blinded to sTTE results and allclinical information.This study was approved by the ethics committees of OsakaEkisaikai Hospital and Okayama University. Pocket-sized pTTEwas performed using the Vscan (GE Medical Systems, Milwau-kee,Wisconsin).Theapical4-chamberviewbythecolorDopplerimages was obtained with sTTE and pTTE, respectively. Theratio of regurgitant jet area to atrial area was then calculated forMR (%MR) and TR (%TR). The severity of regurgitation wasgraded as mild if it occupied 20%, moderate if between 20%and 34%, and severe if 34% in TTE examination.Linear regression analysis was used for the correlation ofvariables of interest. Differences were considered significant atp 0.05.DifferencesbetweensTTEandpTTEresultswerealsocompared with the mean value obtained by sTTE and pTTEusing the Bland-Altman method, with the limits of agreementdefined as 2 SD of the difference between the 2 methods.Echocardiographic measurements were completed for sTTEand pTTE in all patients (feasibility 100%). In the examinationby the well-trained sonographer, there were excellent correlationsin MR jet area, left atrial area, %MR, TR jet area, right atrialarea, and %TR between sTTE and pTTE (r 0.89 to 0.96, p 0.001). Also, there were small systematic differences with closelimits of agreement between sTTE and pTTE measurements,respectively: 20.2 cm
- Published
- 2011