Left ventricle Function Assessment Using Pocket-sized Hand-held Echocardiography and High-end Echocardiography.

Abstract

Introduction: Pocket-sized handheld echocardiography (HHE) has demonstrated its accuracy in a variety of settings compared with standard transthoracic echocardiography (TTE), but in patients with acute coronary syndrome (ACS), it has not been rigorously compared to traditional TTE. Objective: To assess the validity of pocket-sized HHE in providing accurate information regarding left ventricle function in patients admitted with ACS. Methods: This study enrolled patients who were admitted to Hammersmith Hospital with ACS. All patients underwent both comprehensive standard TTE and pocket-sized HHE scans with experienced sonographers. The results from pocket-sized HHE were statistically assessed to determine the intra-device agreement (IDA) compared to standard TTE. Results: Statistical analysis included 60 patients (mean age 63.8 ± 15.2 years). The IDA in assessing left ventricle systolic function was found to be very good (α = 0.867 [ICC range: 0.774–0.922]), for the presence of regional wall motion abnormalities (RWMAs), it was found to be good (α = 0.764 [ICC range: 0.582–0.867]), and for each wall, including anterior, septal, inferior, lateral, apical, and inferolateral wall, it was found to be between fair and good (α = 0.290 [ICC range: 0.082–0.603], α = 0.545 [ICC range: 0.179–0.748], α = 0.688 [ICC range: 0.436–0.827], α = 0.573 [ICC range: 0.228–0.764], α = 0.708 [ICC range: 0.472–0.838], and α = 0.225 [ICC range: -0.401–0.571], respectively). Conclusion: This study demonstrated the validity of using pocket-sized HHE in assessing patients with ACS when performed by an expert operator. The IDA was found to be good in assessing left ventricle systolic function and the presence of RWMAs, but less robust in two specific segments of assessing the severity of RWMAs. However, pocket-sized HHE should not replace standard TTE.