Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice
Background: Data about the epidemiology of valvular heart disease (VHD) in the elderly is scarce. Hand-held ultrasound devices (HUDs) enable point-of-care ultrasound scanning (POCUS) but their use in an elderly population has not been reported for VHD screening in primary practice. Methods: One hu...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | Echo Research and Practice |
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| Online Access: | https://erp.bioscientifica.com/view/journals/echo/6/3/ERP-19-0011.xml |
| _version_ | 1818041282031779840 |
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| author | Catrin Williams Anca Mateescu Emma Rees Kirstie Truman Claire Elliott Bohdana Bahlay Ailsa Wallis Adrian Ionescu |
| author_facet | Catrin Williams Anca Mateescu Emma Rees Kirstie Truman Claire Elliott Bohdana Bahlay Ailsa Wallis Adrian Ionescu |
| author_sort | Catrin Williams |
| collection | DOAJ |
| description | Background: Data about the epidemiology of valvular heart disease (VHD) in the elderly is scarce. Hand-held ultrasound devices (HUDs) enable point-of-care ultrasound scanning (POCUS) but their use in an elderly population has not been reported for VHD screening in primary practice.
Methods: One hundred consecutive subjects aged >70 years without a VHD diagnosis had 2D and colour Doppler POCUS by an accredited sonographer, using a contemporary HUD (Vscan), in a primary practice setting. Patients with left-sided valve pathology identified by Vscan were referred for formal echo in the local tertiary cardiac centre.
Results: Mean age (s.d.) was 79.08 (3.74) years (72–92 years); 61 female. By Vscan, we found five patients with ≥moderate aortic stenosis (AS), eight with ≥moderate mitral regurgitation (MR) and none with ≥moderate aortic regurgitation. In the AS and MR groups each, one patient had valve intervention following from the initial diagnosis by Vscan, two and one respectively are under follow-up in the valve clinic, while two and four respectively refused TTE or follow-up. Two patients with moderate MR by Vscan had mild and mild/moderate MR respectively by TTE and were discharged. Total cost for scanning 100 patients was $18,201 – i.e. $182/patient.
Conclusions: Screening with a hand-held scanner (Vscan), we identified 5/100 elderly subjects who needed valve replacement or follow-up in valve clinic, at a cost of $182/patient. These findings have potential significance for the allocation of resources in the context of an ageing population. |
| first_indexed | 2024-12-10T08:27:56Z |
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| language | English |
| last_indexed | 2024-12-10T08:27:56Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
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| series | Echo Research and Practice |
| spelling | doaj.art-71401bed9a6548398b222e238eb7343f2022-12-22T01:56:11ZengBMCEcho Research and Practice2055-04642055-04642019-08-01637179https://doi.org/10.1530/ERP-19-0011Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practiceCatrin Williams0Anca Mateescu1Emma Rees2Kirstie Truman3Claire Elliott4Bohdana Bahlay5Ailsa Wallis6Adrian Ionescu7Hywel Dda LHB, Carmarthen, UKDirector Prof Bogdan Popescu, University of Medicine and Pharmacy ‘Carol Davila’ – Euroecolab, Bucharest, RomaniaCollege of Health Sciences, Swansea University, Swansea, UKBay Health Network, Swansea, UKABMU University NHS Trust, Morriston, UKABMU University NHS Trust, Morriston, UKABMU University NHS Trust, Morriston, UKCollege of Health Sciences, Swansea University, Swansea, UK; ABMU University NHS Trust, Morriston, UKBackground: Data about the epidemiology of valvular heart disease (VHD) in the elderly is scarce. Hand-held ultrasound devices (HUDs) enable point-of-care ultrasound scanning (POCUS) but their use in an elderly population has not been reported for VHD screening in primary practice. Methods: One hundred consecutive subjects aged >70 years without a VHD diagnosis had 2D and colour Doppler POCUS by an accredited sonographer, using a contemporary HUD (Vscan), in a primary practice setting. Patients with left-sided valve pathology identified by Vscan were referred for formal echo in the local tertiary cardiac centre. Results: Mean age (s.d.) was 79.08 (3.74) years (72–92 years); 61 female. By Vscan, we found five patients with ≥moderate aortic stenosis (AS), eight with ≥moderate mitral regurgitation (MR) and none with ≥moderate aortic regurgitation. In the AS and MR groups each, one patient had valve intervention following from the initial diagnosis by Vscan, two and one respectively are under follow-up in the valve clinic, while two and four respectively refused TTE or follow-up. Two patients with moderate MR by Vscan had mild and mild/moderate MR respectively by TTE and were discharged. Total cost for scanning 100 patients was $18,201 – i.e. $182/patient. Conclusions: Screening with a hand-held scanner (Vscan), we identified 5/100 elderly subjects who needed valve replacement or follow-up in valve clinic, at a cost of $182/patient. These findings have potential significance for the allocation of resources in the context of an ageing population.https://erp.bioscientifica.com/view/journals/echo/6/3/ERP-19-0011.xmlheart valve diseasehand-held ultrasoundscreeningcosts |
| spellingShingle | Catrin Williams Anca Mateescu Emma Rees Kirstie Truman Claire Elliott Bohdana Bahlay Ailsa Wallis Adrian Ionescu Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice Echo Research and Practice heart valve disease hand-held ultrasound screening costs |
| title | Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice |
| title_full | Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice |
| title_fullStr | Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice |
| title_full_unstemmed | Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice |
| title_short | Point-of-care echocardiographic screening for left-sided valve heart disease: high yield and affordable cost in an elderly cohort recruited in primary practice |
| title_sort | point of care echocardiographic screening for left sided valve heart disease high yield and affordable cost in an elderly cohort recruited in primary practice |
| topic | heart valve disease hand-held ultrasound screening costs |
| url | https://erp.bioscientifica.com/view/journals/echo/6/3/ERP-19-0011.xml |
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