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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The utility of handheld echocardiography for early diagnosis of rheumatic heart disease
Journal of the American Society of Echocardiography, Volume 27, No. 1, Year 2014
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Description
Background Rheumatic heart disease (RHD) remains endemic in most of the developing world. Echocardiography has proved highly sensitive for early detection of RHD, but it remains too costly for most low-income settings. Handheld ultrasound machines used to perform handheld echocardiography (HAND) are both less expensive and more portable, possibly making them ideal screening tools. HAND has never been tested for the early diagnosis of RHD. The aim of this study was to evaluate the performance of focused HAND compared with focused standard portable echocardiography for the diagnosis of subclinical RHD. Methods HAND and standard portable echocardiography were performed on 125 Ugandan children, 41 with borderline or definite RHD, and 84 healthy controls. Images were blindly reviewed according to the 2012 World Heart Federation guidelines. Results HAND was highly sensitive (90.2%) and specific (92.9%) for distinguishing between normal patients and those with RHD, but it performed best with definite RHD. HAND overestimated mitral valve morphologic valve abnormalities, being only 66.7% specific for anterior leaflet thickness > 3 mm and 79.0% specific for restricted leaflet motion. False-negative results (n = 4) were due primarily to underestimation of mitral regurgitation length. Conclusions In this population, HAND was highly sensitive and specific for early detection of RHD. HAND functions best as a screening tool with confirmation of positive screening results by fully functional echocardiography machines. Technical advances may enable one-step RHD screening using HAND. The performance of HAND should be studied across diverse populations and in field tests before recommending it for widespread screening. ©2014 by the American Society of Echocardiography.
Authors & Co-Authors
Beaton, Andrea Zawacki
United States, Washington, D.c.
Childrens National Health System
Aliku, Twalib Olega
Uganda, Kampala
Mulago Hospital
Okello, Emmy S.
Uganda, Kampala
Mulago Hospital
Lubega, Sulaiman
Uganda, Kampala
Mulago Hospital
McCarter, Robert
United States, Washington, D.c.
Childrens National Health System
Lwabi, Peter Solomon
Uganda, Kampala
Mulago Hospital
Sable, Craig Andrew
United States, Washington, D.c.
Childrens National Health System
Statistics
Citations: 94
Authors: 7
Affiliations: 2
Identifiers
Doi:
10.1016/j.echo.2013.09.013
ISSN:
08947317
e-ISSN:
10976795
Research Areas
Maternal And Child Health
Noncommunicable Diseases
Study Design
Cross Sectional Study