A Novel and Simple Method Using Pocket-Sized Echocardiography to Screen for Aortic Stenosis

作者：Abe Yukio^*; Ito Makoto; Tanaka Chiharu; Ito Kazato; Naruko Takahiko; Itoh Akira; Haze Kazuo; Muro Takashi; Yoshiyama Minoru; Yoshikawa Junichi

来源：Journal of the American Society of Echocardiography, 2013, 26(6): 589-596.

DOI：10.1016/j.echo.2013.03.008

• Aortic stenosis
• Echocardiography
• Pocket-sized imaging device
• Physical examination
• Cardiac screening

Background: Pocket-sized echocardiography may serve as an initial tool to screen for aortic stenosis (AS). The purpose of this study was to evaluate the usefulness of a novel and simple method using pocket-sized echocardiography to screen for AS. %26lt;br%26gt;Methods: Subjects (n = 130) with systolic ejection murmur or known AS were studied. After physical examination, each aortic cusp%26apos;s opening was visually scored using pocket-sized echocardiography as follows: 0 = not restricted, 1 = restricted, or 2 = severely restricted. The sum of the scores was defined as the visual AS score. On the basis of high-end echocardiography, an aortic valve area index %26lt;0.60 cm(2)/m(2) and an aortic valve area index of 0.60 to 0.85 cm(2)/m(2) were considered to indicate severe and moderate AS, respectively. %26lt;br%26gt;Results: For diagnosing severe AS (n = 27), a visual AS score %26gt;= 4 had sensitivity of 85% and specificity of 89%. For diagnosing moderate to severe AS (n = 57), a visual AS score %26gt;= 3 had sensitivity of 84% and specificity of 90%. The areas under the receiver operating characteristic curves for diagnosing severe and moderate to severe AS with a visual AS score (0.946 and 0.936, respectively) were slightly larger than those for a skilled physical examination (0.917 and 0.898, respectively) (P = NS for both) but were significantly larger than for an aortic valve calcification score also obtained using pocket-sized echocardiography (areas under the curve, 0.816 [P = .0015] and 0.827 [P = .0001], respectively). %26lt;br%26gt;Conclusions: A novel and simple method using pocket-sized echocardiography is useful for rapid grading of AS in subjects with systolic ejection murmur.

• 出版日期2013-6