Introduction
Despite continued efforts to improve the early diagnosis of severe VHD,
the majority of patients with this condition remain undiagnosed and
untreated(1-3). In the United States (U.S.), the estimated prevalence of
VHD is 2.5%, corresponding to a burden of 4.2 to 5.6 million adults; of
these, only 75,600 to 100,800 are diagnosed(1). Due to the high
prevalence among the elderly and as the U.S. shifts to an older
population, the burden in undiagnosed VHD will continue to increase(1).
The burden of valve disease can be attributed to several factors,
including the lack of access to health care(4), missed diagnosis in the
absence of patient symptoms or subtle exam findings(4), and reliance on
diagnosis via echocardiography(1). Given the burden of undiagnosed VHD
and its detrimental effects, early diagnosis is paramount. Further, the
utilization of a screening tool for point-of-care testing, such as a
portable handheld imaging device, may be a promising resource to
overcome some of these hurdles(1).
Several studies have used handheld echocardiography to evaluate LV
function and VHD in the emergency room(5), and inpatient settings(6) and
have been shown to be feasible. Handheld imaging tools have excellent
imaging capabilities, added connectivity, and ease of use, making them
great for diagnosing and managing many diseases.
There is limited data on the utility of handheld imaging tools to screen
for VHD. A few studies have shown a trend towards comparable accuracy
and reliability of the handheld device compared to a standard
echocardiogram(7-9). The utility of handheld point-of-care cardiac
imaging in risk stratifying acutely ill patients based on their LV
function infected with Corona Virus-2019 (COVID 19) was also recently
highlighted in an observational study from New York during the COVID 19
pandemic(10).
It is conceivable that handheld imaging tools, like the Vscan Extend
(GE, Wisconsin), will enhance the cardiac physical exam in the primary
care setting, allowing for an earlier diagnosis of significant VHD, left
ventricular function, and appropriate specialty referral.
In this study, we aimed to assess the adoptability and accuracy of
echocardiographic Vscan Extend (GE, Wisconsin) assessments in the hands
of previously untrained users in the primary care setting to diagnose
VHD and left ventricular function.