Screening echocardiography in a developing country
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Background:The use of tele-echocardiograms could be useful for improving access of patients to echocardiographic evaluation in places where there is a shortage of trained physicians. It was evaluated the agreement between a physician sonographer and another
health professional with basic training to acquire transthoracic images, assessed by a remote echocardiographer. Methods:174 patients underwent echocardiography by a physician level III training in Echo. A moving image protocol (MPEG format, 3 cycles for each image) was stored: 2D parasternal long axis, apical four chambers with and without color. Soon after, a nurse with 20 hours of training in Echo, unaware of the result of the report, acquired the same protocol. The exams were randomized and sent to a remote observer, another echocardiographer level III, blinded to the sonographer’s status, to recognize the presence of the any of the following abnormalities: left ventricular enlargement, hypertrophy and systolic dysfunction; right ventricular enlargement, left atrium enlarge ment and left sided valvopathy at least moderate. Agreement was evaluated by kappa concordance.Results: It was analyzed 108 females and 66 males, median age= 61 y [P.25=50-P.75=72]; LV ejection fraction= 64 % [58-69] and body mass index= 27.6 kg/m2 [24.5-32.5]. There was a good concordance between the evaluators. All the indices analyzed showed agreement above 0.55 and statistic significance (left ventricular enlargement - 0.84; left ventricular hypertrophy - 0.84; systolic left ventricular dysfunction - 0.82; right ventricle enlargement - 0.72; left atrial enlargement - 0.80; valvopathy - 0.56). Conclusions: The image acquisition by a tele-echocardiogram screening may
be acquired by non-physician professionals with minimum training.
Abstract
Assunto
Ecocardiografia
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Ecocardiografia
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https://academic.oup.com/eurpub/article/30/Supplement_5/ckaa166.073/5914084