Valvular heart disease screening using a point-of-care ultrasound device according to physician experience: Non-expert versus expert.

BACKGROUND

A point-of-care ultrasound (POCUS) device (Vscan™) is reliable in valvular heart disease (VHD) screening when used by expert physicians.

AIMS: To compare the feasibility and accuracy of a POCUS device in VHD screening according to physician experience (non-expert versus expert).

METHODS

In a prospective study including 240 outpatients referred to the echocardiography laboratory, POCUS was performed by one expert cardiologist and one non-expert cardiologist blinded to each other. These were then compared to standard transthoracic echocardiography performed by an expert cardiologist (gold standard). Left-sided VHD and significant tricuspid regurgitation were systematically recorded.

RESULTS

Standard transthoracic echocardiography identified 250 cases of VHD in 240 patients. VHD was correctly identified in 247 of 250 cases (98.8%) by expert POCUS and in 219 of 250 cases (87.6%) by non-expert POCUS. Expert POCUS was highly sensitive (99%) and specific (93%) for VHD screening. Non-expert POCUS was also sensitive (88%) and specific (88%). The efficiency of POCUS was high for significant mitral, aortic and tricuspid regurgitation: sensitivity and specificity were 100% for expert POCUS and 94% and 99%, respectively, for non-expert POCUS.

CONCLUSION

POCUS performed by a non-expert physician is reliable for VHD screening and should be used as a triage tool to exclude the diagnosis of VHD or to refer patients to an echocardiography laboratory.