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01.05.2016 | original article

Pocket-size imaging device as a screening tool for aortic stenosis

verfasst von: Tatjana Golob Gulič, Jana Makuc, Gregor Prosen, Dejan Dinevski

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 9-10/2016

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Summary

Aim

The aim of this study was to assess the usefulness of a pocket-size imaging device in the hands of a noncardiologist as a screening tool for diagnosing aortic stenosis in individuals with newly discovered systolic murmur.

Methods and results

A total of 200 consecutive patients with systolic murmur were included; a limited focused cardiac ultrasound was performed with a pocket-size imaging device and compared to standard echocardiography. It was performed by a noncardiologist with no formal training in echocardiography. In all, 150 patients had morphological changes on the aortic valve, 77 had more than mild aortic stenosis, 30 had more than mild mitral regurgitation, 64 patients had more than moderate hypertrophy, 113 had more than moderately enlarged left atriums, and 3 had severely enlarged left ventricles. There were no significant difference in recognizing severe changes between Vscan focused cardiac ultrasound and comprehensive echocardiography.

Conclusion

Pocket-size ultrasound imaging devices without continuous and pulse wave Doppler modalities can, even in the hands of a noncardiologist with limited cardiac ultrasound instructions with high sensitivity and specificity, be a useful tool for detecting more than mild aortic stenosis and more than mild mitral regurgitation. As such a focused cardiac ultrasound can be an extension of physical examinations for patients with newly discovered systolic murmur.
Literatur
1.
Zurück zum Zitat Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Barwolf C, Levang OW, Tornos P, Vanoverschelde JL, Vermeer F, Boersma E, Ravaud P, Vahanian A. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003;24:1231–43.CrossRefPubMed Iung B, Baron G, Butchart EG, Delahaye F, Gohlke-Barwolf C, Levang OW, Tornos P, Vanoverschelde JL, Vermeer F, Boersma E, Ravaud P, Vahanian A. A prospective survey of patients with valvular heart disease in Europe: the Euro Heart Survey on Valvular Heart Disease. Eur Heart J. 2003;24:1231–43.CrossRefPubMed
3.
Zurück zum Zitat Faggiano P, Canterin FA, Baldessin F, Lorusso R, D’Aloia A, Dei L. Epidemiology and cardiovascular risk factors of aortic stenosis. Cardiovasc Ultrasound. 2006;4:27.CrossRefPubMedPubMedCentral Faggiano P, Canterin FA, Baldessin F, Lorusso R, D’Aloia A, Dei L. Epidemiology and cardiovascular risk factors of aortic stenosis. Cardiovasc Ultrasound. 2006;4:27.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Das P, Pocock C, Chambers J. The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. QJM. 2000;93:685–8.CrossRefPubMed Das P, Pocock C, Chambers J. The patient with a systolic murmur: severe aortic stenosis may be missed during cardiovascular examination. QJM. 2000;93:685–8.CrossRefPubMed
6.
Zurück zum Zitat Etchells E, Glenns V, Shadowitz S, Bell C, Siu S. A bedside clinical prediction rule for detecting moderate or severe aortic stenosis. J Gen Intern Med. 1998;13(10):699–704.CrossRefPubMedPubMedCentral Etchells E, Glenns V, Shadowitz S, Bell C, Siu S. A bedside clinical prediction rule for detecting moderate or severe aortic stenosis. J Gen Intern Med. 1998;13(10):699–704.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Roldan CA, Shively BK, Crawford MH. Value of the cardiovascular physical examination for detecting valvular heart disease in asymptomatic subjects. Am J Cardiol. 1996;77(15):1327–31.CrossRefPubMed Roldan CA, Shively BK, Crawford MH. Value of the cardiovascular physical examination for detecting valvular heart disease in asymptomatic subjects. Am J Cardiol. 1996;77(15):1327–31.CrossRefPubMed
8.
Zurück zum Zitat Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, Iung B, Otto CM, Pellikka PA. Quiñones M. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr. 2009;10(1):1–25.CrossRefPubMed Baumgartner H, Hung J, Bermejo J, Chambers JB, Evangelista A, Griffin BP, Iung B, Otto CM, Pellikka PA. Quiñones M. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. Eur J Echocardiogr. 2009;10(1):1–25.CrossRefPubMed
9.
Zurück zum Zitat Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, Flachskampf F, Hall R, Iung B, Kasprzak J, Nataf P, Tornos P, Torracca L, Wenink A. Guidelines on the management of valvular heart disease, The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28:230–68.PubMed Vahanian A, Baumgartner H, Bax J, Butchart E, Dion R, Filippatos G, Flachskampf F, Hall R, Iung B, Kasprzak J, Nataf P, Tornos P, Torracca L, Wenink A. Guidelines on the management of valvular heart disease, The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28:230–68.PubMed
10.
Zurück zum Zitat ESC/EACTS Guidelines. Guidelines on management of valvular heart disease (version 2012). Eur Heart J. 2012;33:2451–96.CrossRef ESC/EACTS Guidelines. Guidelines on management of valvular heart disease (version 2012). Eur Heart J. 2012;33:2451–96.CrossRef
11.
Zurück zum Zitat Otto CM. Valvular aortic stenosis disease severity and timing of intervention. JACC. 2006;47(11):2141–51.CrossRefPubMed Otto CM. Valvular aortic stenosis disease severity and timing of intervention. JACC. 2006;47(11):2141–51.CrossRefPubMed
12.
Zurück zum Zitat Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe asymptomatic aortic valve stenosis. N Engl J Med. 2000;343:611–7.CrossRefPubMed Rosenhek R, Binder T, Porenta G, et al. Predictors of outcome in severe asymptomatic aortic valve stenosis. N Engl J Med. 2000;343:611–7.CrossRefPubMed
13.
Zurück zum Zitat Rosenhek R, Klaar U, Schemper M, et al. Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J. 2004;25:199–205.CrossRefPubMed Rosenhek R, Klaar U, Schemper M, et al. Mild and moderate aortic stenosis. Natural history and risk stratification by echocardiography. Eur Heart J. 2004;25:199–205.CrossRefPubMed
14.
Zurück zum Zitat Rosenhek R, Binder T, Porenta G, Lang I, Christ G, Schemper M, Maurer G, Baumgartner H. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med. 2000;343:611–17.CrossRefPubMed Rosenhek R, Binder T, Porenta G, Lang I, Christ G, Schemper M, Maurer G, Baumgartner H. Predictors of outcome in severe, asymptomatic aortic stenosis. N Engl J Med. 2000;343:611–17.CrossRefPubMed
15.
Zurück zum Zitat Otto CM, Burwash IG, Legget ME, Munt BI, Fujioka M, Healy NL, Kraft CD, Miyake-Hull CI, Schwaegler RG. Prospective study of asymptomatic valvular aortic stenosis clinical, echocardiographic, and exercise predictors of outcome. Circulation. 1997;95:2262–70.CrossRefPubMed Otto CM, Burwash IG, Legget ME, Munt BI, Fujioka M, Healy NL, Kraft CD, Miyake-Hull CI, Schwaegler RG. Prospective study of asymptomatic valvular aortic stenosis clinical, echocardiographic, and exercise predictors of outcome. Circulation. 1997;95:2262–70.CrossRefPubMed
16.
Zurück zum Zitat Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 Guidelines update for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Soc Echocardiogr. 2003;16:1091–110.PubMed Cheitlin MD, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davis JL, et al. ACC/AHA/ASE 2003 Guidelines update for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Soc Echocardiogr. 2003;16:1091–110.PubMed
17.
Zurück zum Zitat Nihoyannopoulos P, Fox K, Fraser A, Pinto F. EAE laboratory standards and accreditation. Eur J Echocardiogr. 2007;8:80–7.CrossRefPubMed Nihoyannopoulos P, Fox K, Fraser A, Pinto F. EAE laboratory standards and accreditation. Eur J Echocardiogr. 2007;8:80–7.CrossRefPubMed
18.
Zurück zum Zitat Popescu B, Andrade MJ, Badano L, Fox K, Flachskampf F, Lanccellotti P, et al. EAE recommendations for training, competence and quality improvement in echocardiography. Eur J Echocardiogr. 2009;10:893–905.CrossRefPubMed Popescu B, Andrade MJ, Badano L, Fox K, Flachskampf F, Lanccellotti P, et al. EAE recommendations for training, competence and quality improvement in echocardiography. Eur J Echocardiogr. 2009;10:893–905.CrossRefPubMed
19.
Zurück zum Zitat Evangelista A, Flachskampf F, Lancelloti P, Badano L, Aguilar R, Monaghan M, Zamorano J, Nihoyannopoulos P. European Association of Echocardiography recommendations for standardisation of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr. 2008;9:438–48.CrossRefPubMed Evangelista A, Flachskampf F, Lancelloti P, Badano L, Aguilar R, Monaghan M, Zamorano J, Nihoyannopoulos P. European Association of Echocardiography recommendations for standardisation of performance, digital storage and reporting of echocardiographic studies. Eur J Echocardiogr. 2008;9:438–48.CrossRefPubMed
20.
Zurück zum Zitat Popescu BA, Stefanidis A, Nihoyannopoulos P, Fox KF, Ray S, Cardim N, Rigo F, Badano LP, Fraser AG, Pinto F, Zamorano JL, Habib G, Maurer G, Lancellotti P. Updated standards and processes for accreditation of echocardiographic laboratories from The European Association of Cardiovascular Imaging: an executive summary. Eur Heart J Cardiovasc Imaging. 2014;15(11):1188–93.CrossRefPubMed Popescu BA, Stefanidis A, Nihoyannopoulos P, Fox KF, Ray S, Cardim N, Rigo F, Badano LP, Fraser AG, Pinto F, Zamorano JL, Habib G, Maurer G, Lancellotti P. Updated standards and processes for accreditation of echocardiographic laboratories from The European Association of Cardiovascular Imaging: an executive summary. Eur Heart J Cardiovasc Imaging. 2014;15(11):1188–93.CrossRefPubMed
21.
Zurück zum Zitat Sicari R, Galderisi M, Voigt JU, Habib G, Zamorano JL, Lancellotti P, Badano LP. The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography. Eur J Echocardiogr. 2011;12(2):85–7.CrossRefPubMed Sicari R, Galderisi M, Voigt JU, Habib G, Zamorano JL, Lancellotti P, Badano LP. The use of pocket-size imaging devices: a position statement of the European Association of Echocardiography. Eur J Echocardiogr. 2011;12(2):85–7.CrossRefPubMed
22.
Zurück zum Zitat Mondillo S, Giannotti G, Innelli P, Ballo PC, Galderisi M. Hand-held echocardiography: its use and usefulness. Int J Cardiol. 2006;111:1–5.CrossRefPubMed Mondillo S, Giannotti G, Innelli P, Ballo PC, Galderisi M. Hand-held echocardiography: its use and usefulness. Int J Cardiol. 2006;111:1–5.CrossRefPubMed
23.
Zurück zum Zitat Galderisi M, Santoro A, Versiero M, Lomoriello VS, Esposito R, Raia R, Farina F, Schiattarella PL, Bonito M, Olibet M, Simon G. Improved cardiovascular diagnostic accuracy by pocket size imaging device in non-cardiologic outpatients: the NaUSiCa (Naples Ultrasound Stethoscope in Cardiology) study. Cardiovasc Ultrasound. 2010;8:51.CrossRefPubMedPubMedCentral Galderisi M, Santoro A, Versiero M, Lomoriello VS, Esposito R, Raia R, Farina F, Schiattarella PL, Bonito M, Olibet M, Simon G. Improved cardiovascular diagnostic accuracy by pocket size imaging device in non-cardiologic outpatients: the NaUSiCa (Naples Ultrasound Stethoscope in Cardiology) study. Cardiovasc Ultrasound. 2010;8:51.CrossRefPubMedPubMedCentral
24.
Zurück zum Zitat Mjolstad OC, Dalen H, Graven T, Kleinau JO, Salvesen O, Haugen BO. Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department. Eur J Internal Med. 2012;23:185–91.CrossRef Mjolstad OC, Dalen H, Graven T, Kleinau JO, Salvesen O, Haugen BO. Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department. Eur J Internal Med. 2012;23:185–91.CrossRef
25.
Zurück zum Zitat Fukuda S, Shimada K, Kawasaki T, Fujimoto H, Maeda K, Inanami H, Yoshida K, Jissho S, Taguchi H, Yoshiyama M, Yoshikawa J. Pocket-sized transthoracic echocardiography device for the measurement of cardiac chamber size and function. Circ J. 2009;73:1092–96.CrossRefPubMed Fukuda S, Shimada K, Kawasaki T, Fujimoto H, Maeda K, Inanami H, Yoshida K, Jissho S, Taguchi H, Yoshiyama M, Yoshikawa J. Pocket-sized transthoracic echocardiography device for the measurement of cardiac chamber size and function. Circ J. 2009;73:1092–96.CrossRefPubMed
26.
Zurück zum Zitat Mjolstad OC, Dalen H, Graven T, Kleinau JO, Salvesen O, Haugen BO. Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department. Eur J of Internal Med. 2012;23:185–91.CrossRef Mjolstad OC, Dalen H, Graven T, Kleinau JO, Salvesen O, Haugen BO. Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department. Eur J of Internal Med. 2012;23:185–91.CrossRef
27.
Zurück zum Zitat Skjetne K, Graven T, Haugen BO, Salvesen O, Kleinau JO, Dalen H. Diagnostic influence of cardiovascular screening by pocket-size ultrasound in a cardiac unit. Eur J Echocardiogr. 2011;12:737–43.CrossRefPubMedPubMedCentral Skjetne K, Graven T, Haugen BO, Salvesen O, Kleinau JO, Dalen H. Diagnostic influence of cardiovascular screening by pocket-size ultrasound in a cardiac unit. Eur J Echocardiogr. 2011;12:737–43.CrossRefPubMedPubMedCentral
28.
Zurück zum Zitat Cardim N, Golfin CF, Ferreira D, Aubele A, Toste J, Cobos MA, Carmelo V, Nunes I, Oliveira AG, Zamorano J. Usefulness of a new miniaturized echocardiographic system in outpatient cardiology consultations as an extension of physical examination. J Am Soc Echocardiogr. 2011;24:117–24.CrossRefPubMed Cardim N, Golfin CF, Ferreira D, Aubele A, Toste J, Cobos MA, Carmelo V, Nunes I, Oliveira AG, Zamorano J. Usefulness of a new miniaturized echocardiographic system in outpatient cardiology consultations as an extension of physical examination. J Am Soc Echocardiogr. 2011;24:117–24.CrossRefPubMed
29.
Zurück zum Zitat Alexander JH, Peterson ED, Chen AY. Feasibility of point-of-care echo by non-cardiologist physician to assess left ventricular function, pericardial effusion, mitral regurgitation and aortic valve thickening. Circulation. 2001;104:334. Alexander JH, Peterson ED, Chen AY. Feasibility of point-of-care echo by non-cardiologist physician to assess left ventricular function, pericardial effusion, mitral regurgitation and aortic valve thickening. Circulation. 2001;104:334.
30.
Zurück zum Zitat Badano LP, Nucifora G, Stacul S, Gianfagna P, Pericoli M, DelMestre L, et al. Improved workflow sonographer productivity, and cost-effectiveness of echocardiographic service for inpatients by using miniaturized systems. Eur J Echocardiogr. 2009;10:537–42.CrossRefPubMed Badano LP, Nucifora G, Stacul S, Gianfagna P, Pericoli M, DelMestre L, et al. Improved workflow sonographer productivity, and cost-effectiveness of echocardiographic service for inpatients by using miniaturized systems. Eur J Echocardiogr. 2009;10:537–42.CrossRefPubMed
31.
Zurück zum Zitat Mehta M, Jacobson T, Peters D, Le E, Chadderdon S, Allen AJ, Caughey AB, Kaul S. Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition. JACC Cardiovasc Imaging. 2014;7(10):983–90.CrossRefPubMed Mehta M, Jacobson T, Peters D, Le E, Chadderdon S, Allen AJ, Caughey AB, Kaul S. Handheld ultrasound versus physical examination in patients referred for transthoracic echocardiography for a suspected cardiac condition. JACC Cardiovasc Imaging. 2014;7(10):983–90.CrossRefPubMed
32.
Zurück zum Zitat Khan HA, Wineinger NE, Uddin PQ, Mehta HS, Rubenson DS, Topol EJ. Can hospital rounds with pocket ultrasound by cardiologists reduce standard echocardiography? Am J Med. 2014;127(7):669.CrossRefPubMedPubMedCentral Khan HA, Wineinger NE, Uddin PQ, Mehta HS, Rubenson DS, Topol EJ. Can hospital rounds with pocket ultrasound by cardiologists reduce standard echocardiography? Am J Med. 2014;127(7):669.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Gianstefani S, Catibog N, Whittaker RA, Ioannidis GA, Vecchio V, Wathen PT, Douiri A, Reiken J, Monaghan MJ. Pocket-size imaging device: effectiveness for ward-based transthoracic studies. Eur Heart J Cardiovasc Imaging. 2013;14(12):1132–9.CrossRefPubMed Gianstefani S, Catibog N, Whittaker RA, Ioannidis GA, Vecchio V, Wathen PT, Douiri A, Reiken J, Monaghan MJ. Pocket-size imaging device: effectiveness for ward-based transthoracic studies. Eur Heart J Cardiovasc Imaging. 2013;14(12):1132–9.CrossRefPubMed
34.
Zurück zum Zitat Spencer T, Anderson AS, Bhargava A, Bales AC, Sorrentino M, Furlong K, Lang RM. Physician-performed point-of-care echocardiography using a laptop platform compared with physical examination in the cardiovascular patient. Am J Cardiol 2001; 37(8):2013–8. Spencer T, Anderson AS, Bhargava A, Bales AC, Sorrentino M, Furlong K, Lang RM. Physician-performed point-of-care echocardiography using a laptop platform compared with physical examination in the cardiovascular patient. Am J Cardiol 2001; 37(8):2013–8.
35.
Zurück zum Zitat Abe Y, Ito M, Tanaka C, Ito K, Naruko T, Itoh A, Haze K, Muro T, Yoshiyama M. A novel and simple method using pocket-sized echocardiography to screen for aortic stenosis. J Am Soc Echocardiogr. 2013;26(6):589–96.CrossRefPubMed Abe Y, Ito M, Tanaka C, Ito K, Naruko T, Itoh A, Haze K, Muro T, Yoshiyama M. A novel and simple method using pocket-sized echocardiography to screen for aortic stenosis. J Am Soc Echocardiogr. 2013;26(6):589–96.CrossRefPubMed
36.
Zurück zum Zitat Neskovic AN, Edvardsen T, Galderisi M, Garbi M, Gullace G, Jurcut R, Dalen H, Hagendorff A, Lancellotti P, Popescu BA, Sicari R, Stefanidis A. Focus cardiac ultrasound: the European Association of Cardiovascular Imaging viewpoint. Eur Heart J Cardiovasc Imaging. 2014;15(9):956–60.CrossRefPubMed Neskovic AN, Edvardsen T, Galderisi M, Garbi M, Gullace G, Jurcut R, Dalen H, Hagendorff A, Lancellotti P, Popescu BA, Sicari R, Stefanidis A. Focus cardiac ultrasound: the European Association of Cardiovascular Imaging viewpoint. Eur Heart J Cardiovasc Imaging. 2014;15(9):956–60.CrossRefPubMed
37.
Zurück zum Zitat Spencer KT, Kimura BJ, Korcarz CE, Pellikka PA, Rahko PS, Siegel RJ. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2013;26:567–81.CrossRefPubMed Spencer KT, Kimura BJ, Korcarz CE, Pellikka PA, Rahko PS, Siegel RJ. Focused cardiac ultrasound: recommendations from the American Society of Echocardiography. J Am Soc Echocardiogr. 2013;26:567–81.CrossRefPubMed
38.
Zurück zum Zitat Via G, International Liaison Committee on Focused Cardiac UltraSound (ILC-FoCUS), International Conference on Focused Cardiac UltraSound (IC-FoCUS), et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014;27(7):683.e1–33.CrossRef Via G, International Liaison Committee on Focused Cardiac UltraSound (ILC-FoCUS), International Conference on Focused Cardiac UltraSound (IC-FoCUS), et al. International evidence-based recommendations for focused cardiac ultrasound. J Am Soc Echocardiogr. 2014;27(7):683.e1–33.CrossRef
39.
Zurück zum Zitat De Cara JM, Lang RM, Koch R, Bala R, Penzotti J, Spencer KT. The use of small personal ultrasound devices by internists without formal training in echocardiography. Eur J Echocardiogr. 2003;4:141–7.CrossRef De Cara JM, Lang RM, Koch R, Bala R, Penzotti J, Spencer KT. The use of small personal ultrasound devices by internists without formal training in echocardiography. Eur J Echocardiogr. 2003;4:141–7.CrossRef
40.
Zurück zum Zitat Kimura BJ, Gilcrease GV, Showalter BK, Phan JN, Wolfson T. Diagnostic performance of a pocket-sized ultrasound device for quick-look cardiac imaging. Am J Emerg Med. 2012;30:32–6.CrossRefPubMed Kimura BJ, Gilcrease GV, Showalter BK, Phan JN, Wolfson T. Diagnostic performance of a pocket-sized ultrasound device for quick-look cardiac imaging. Am J Emerg Med. 2012;30:32–6.CrossRefPubMed
41.
Zurück zum Zitat Cowie B, Kluger R. Evaluation of systolic murmurs using transthoracic echocardiography by anaesthetic trainees. Anaesthesia. 2011;66:268–73.CrossRefPubMed Cowie B, Kluger R. Evaluation of systolic murmurs using transthoracic echocardiography by anaesthetic trainees. Anaesthesia. 2011;66:268–73.CrossRefPubMed
42.
Zurück zum Zitat Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999;15(6):816–22.CrossRefPubMed Roques F, Nashef SA, Michel P, Gauducheau E, de Vincentiis C, Baudet E, Cortina J, David M, Faichney A, Gabrielle F, Gams E, Harjula A, Jones MT, Pintor PP, Salamon R, Thulin L. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients. Eur J Cardiothorac Surg. 1999;15(6):816–22.CrossRefPubMed
43.
Zurück zum Zitat Mjølstad OC, Andersen GN, Dalen H, Graven T, Skjetne K, Kleinau JO, Haugen BO. Feasibility and reliability of point-of-care pocket-size echocardiography performed by medical residents. Eur Heart J Cardiovasc Imaging 2013;14(12):1195–202.CrossRefPubMedPubMedCentral Mjølstad OC, Andersen GN, Dalen H, Graven T, Skjetne K, Kleinau JO, Haugen BO. Feasibility and reliability of point-of-care pocket-size echocardiography performed by medical residents. Eur Heart J Cardiovasc Imaging 2013;14(12):1195–202.CrossRefPubMedPubMedCentral
44.
Zurück zum Zitat Panoulas VF, Daigeler A, Malaweera ASN, Lota AS, Baskaran D, Rahman S, Nihoyannopoulos P. Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors. Eur Heart J Cardiovasc Imaging. 2013;14(4):323–30.CrossRefPubMed Panoulas VF, Daigeler A, Malaweera ASN, Lota AS, Baskaran D, Rahman S, Nihoyannopoulos P. Pocket-size hand-held cardiac ultrasound as an adjunct to clinical examination in the hands of medical students and junior doctors. Eur Heart J Cardiovasc Imaging. 2013;14(4):323–30.CrossRefPubMed
45.
Zurück zum Zitat Price S, Via G, Sloth E, Guarracino F, Breitkreutz R, Catena E, Talmor D, World Interactive Network Focused On Critical UltraSound ECHO-ICU Group. Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound. 2008;6:49.CrossRefPubMedPubMedCentral Price S, Via G, Sloth E, Guarracino F, Breitkreutz R, Catena E, Talmor D, World Interactive Network Focused On Critical UltraSound ECHO-ICU Group. Echocardiography practice, training and accreditation in the intensive care: document for the World Interactive Network Focused on Critical Ultrasound (WINFOCUS). Cardiovasc Ultrasound. 2008;6:49.CrossRefPubMedPubMedCentral
Metadaten
Titel
Pocket-size imaging device as a screening tool for aortic stenosis
verfasst von
Tatjana Golob Gulič
Jana Makuc
Gregor Prosen
Dejan Dinevski
Publikationsdatum
01.05.2016
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 9-10/2016
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0904-6