In:
Circulation: Cardiovascular Imaging, Ovid Technologies (Wolters Kluwer Health), Vol. 8, No. 1 ( 2015-01)
Kurzfassung:
Rheumatic heart disease (RHD) remains a major public health problem worldwide. Although early diagnosis by echocardiography may potentially play a key role in developing active surveillance, systematic evaluation of simple approaches in resource poor settings are needed. Methods and Results— We prospectively compared focused cardiac ultrasound (FCU) to a reference approach for RHD screening in a school children population. FCU included (1) the use of a pocket-sized echocardiography machine, (2) nonexpert staff (2 nurses with specific training), and (3) a simplified set of echocardiographic criteria. The reference approach used standardized echocardiographic examination, reviewed by an expert cardiologist, according to 2012 World Heart Federation criteria. Among the 6 different echocardiographic criteria, first tested in a preliminary phase, mitral regurgitation jet length ≥2 cm or any aortic regurgitation was considered best suited to be FCU criteria. Of the 1217 subjects enrolled (mean, 9.6±1 years; 49.6% male), 49 (4%) were diagnosed with RHD by the reference approach. The sensitivity of FCU for the detection of RHD was 83.7% (95% confidence interval, 73.3–94.0) for nurse A and 77.6% (95% confidence interval, 65.9–89.2) for nurse B. FCU yielded a specificity of 90.9% (95% confidence interval, 89.3–92.6) and 92.0% (95% confidence interval, 90.4–93.5) according to users. Percentage of agreement among nurses was 91.4%. Conclusions— FCU by nonexperts using pocket devices seems feasible and yields acceptable sensitivity and specificity for RHD detection when compared with the state-of-the-art approach, thereby opening new perspectives for mass screening for RHD in low-resource settings.
Materialart:
Online-Ressource
ISSN:
1941-9651
,
1942-0080
DOI:
10.1161/CIRCIMAGING.114.002324
Sprache:
Englisch
Verlag:
Ovid Technologies (Wolters Kluwer Health)
Publikationsdatum:
2015
ZDB Id:
2440475-5
Bookmarklink