Copyright © 2005, The European Society of Cardiology
Reliability of cardiac dimensions and valvular regurgitation assessment by sonographers using hand-carried ultrasound devices
aCardiology Department, S. Spirito Hospital, Rome, Italy
bIstituto Superiore di Sanità, Rome, Italy
Received 5 March 2005; received in revised form 21 May 2005; accepted after revision 1 June 2005.
* Corresponding author. via Annia 26, 00184 Rome, Italy. Tel.: +39 06 709 6275; fax: +39 06 6835 4880. claudiocoletta{at}interfree.it
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Abstract |
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Aim We sought to assess the reliability of some basic echocardiographic data obtained by trained sonographers using a hand-held ultrasound device.
Methods One hundred and twelve consecutive patients (mean age 61, 64 males) referred for in-hospital or ambulatory routine echocardiography were considered. All patients underwent two-dimensional and colour Doppler examination performed by a trained sonographer equipped with a hand-held ultrasound device and by a certified cardiologist equipped with a standard platform, in random order. Indexed left ventricular end-diastolic and end-systolic transverse diameters, aortic root, end-systolic left atrium transverse diameter, end-diastolic interventricular septum and posterior wall thickness were calculated by two-dimensional left parasternal long-axis view in blind conditions. Mitral and aortic valve regurgitation were investigated by colour-Doppler imaging on parasternal and apical views and compared using a 0 to 4 semi-quantitative score.
Results Overall feasibility was high for both settings (sonographers: 93%; cardiologists: 95%; P not significant). Excellent concordance of end-diastolic diameter (kappa 0.75), left atrium (kappa 0.76) and interventricular septum thickness (kappa 0.77) results was found. Good concordance was observed for end-systolic diameter (kappa 0.66), aortic root (kappa 0.64) and posterior wall thickness (kappa 0.67) results. A high linear correlation between the couples of results was present for all parameters. A good agreement of the mitral (kappa 0.66) and aortic (kappa 0.84) regurgitation scores was also found, with a low prevalence of discordant results (mitral regurgitation: 22%, aortic regurgitation: 9%) and no 
2-point discrepancies.
Conclusion In a general population referred for Doppler echocardiography, basic cardiac linear dimensions and valvular regurgitation severity assessment by trained sonographers using hand-held ultrasound devices appear accurate and reliable for routine clinical use.
Keywords: Portable echocardiography; Sonographers; Cardiac dimensions; Valvular regurgitation