The importance of patient characteristics, operators, and image quality for the accuracy of heart failure diagnosis by general practitioners using handheld ultrasound devices.

Aims: To evaluate whether the characteristics of patients, operators, and image quality could explain the accuracy of heart failure (HF) diagnostics by general practitioners (GPs) using handheld ultrasound devices (HUDs) with automatic decision-support software and telemedical support.

Methods And Results: Patients referred to an outpatient cardiac clinic due to symptoms indicating HF were examined by one of five GPs after dedicated training. In total, 166 patients were included [median (inter-quartile range) age 73 (63-78) years; mean ± standard deviation ejection fraction 53 ± 10%].

The importance of concomitant mitral regurgitation for estimates of mitral valve area by pressure half time in patients with chronic rheumatic heart disease.

Aims: Aim was to study how concomitant mitral regurgitation (MR) assessed by qualitative and quantitative methods influence mitral valve area (MVA) calculations by the pressure half time method (MVA) compared to reference MVA (planimetry) in patients with rheumatic heart disease.

Methods And Results: In 72 patients with chronic rheumatic heart disease, MVA was calculated as 220 divided by the pressure half time of the mitral early inflow Doppler spectrum. Direct measurement by planimetry was used as reference MVA and was mean (SD) 0.

Clinical Influence of Handheld Ultrasound, Supported by Automatic Quantification and Telemedicine, in Suspected Heart Failure.

Early and correct heart failure (HF) diagnosis is essential to improvement of patient care. We aimed to evaluate the clinical influence of handheld ultrasound device (HUD) examinations by general practitioners (GPs) in patients with suspected HF with or without the use of automatic measurement of left ventricular (LV) ejection fraction (autoEF), mitral annular plane systolic excursion (autoMAPSE) and telemedical support. Five GPs with limited ultrasound experience examined 166 patients with suspected HF (median interquartile range = 70 (63-78) y; mean ± SD EF = 53 ± 10%).

Real-time automatic quantification of left ventricular function by hand-held ultrasound devices in patients with suspected heart failure: a feasibility study of a diagnostic test with data from general practitioners, nurses and cardiologists.

Objectives: To evaluate the feasibility and reliability of hand-held ultrasound (HUD) examinations with real-time automatic decision-making software for ejection fraction (autoEF) and mitral annular plane systolic excursion (autoMAPSE) by novices (general practitioners), intermediate users (registered cardiac nurses) and expert users (cardiologists), respectively, compared to reference echocardiography by cardiologists in an outpatient cohort with suspected heart failure (HF).

Design: Feasibility study of a diagnostic test.

Setting And Participants: 166 patients with suspected HF underwent HUD examinations with autoEF and autoMAPSE measurements by five novices, three intermediate-skilled users and five experts.

Complete embolization of a mechanical aortic valve during trail running-a case report with a lucky ending.

Background: Complete embolization of a prosthetic heart valve is extremely rare and dangerous. This case reports a total embolization of a mechanical aortic valve and contributes to the literature regarding the diagnostic challenges related to infective endocarditis and follow-up after valvular surgery.

Case Summary: A 28-year-old male 11.

Reliability and agreement of point-of-care carotid artery examinations by experts using hand-held ultrasound devices in patients with ischaemic stroke or transitory ischaemic attack.

Objectives: To investigate the reliability and agreement of hand-held ultrasound devices (HUDs) compared with conventional duplex ultrasound (HIGH) in examination for carotid stenosis in patients with suspected transitory ischaemic attack (TIA) or ischaemic stroke.

Methods: Cardiologists, experienced in carotid ultrasound, examined patients admitted to a community hospital with suspected stroke or TIA. Patients were first examined by an HUD and second by HIGH as per usual care.

Feasibility and Clinical Impact of Point-of-Care Carotid Artery Examinations by Experts using Hand-Held Ultrasound Devices in Patients with Ischemic Stroke or Transitory Ischemic Attack.

Background And Purpose: To evaluate the feasibility and clinical influence of carotid artery examinations in patients admitted with stroke or TIA with hand-held ultrasound by experts, to identify individuals not in need of further carotid artery diagnostics.

Materials And Methods: Cardiologists experienced in carotid ultrasound examined 80 patients admitted to a stroke unit with suspected stroke or TIA with hand-held ultrasound devices (HUD). Grey scale and color Doppler images were stored using a GE Vscan with dual probe (phased array and linear transducer).

Measurement of high-sensitivity troponin-I in suspected coronary-related chest pain in Emergency Departments.

Background: The study aimed to evaluate a new algorithm based on analyses of high-sensitivity troponin I for rapid diagnostic clarification in cases of suspected cardiac chest pain.

Material And Method: Two time periods - before (01.10.

Short-term outcome after open-heart surgery for severe chronic rheumatic heart disease in a low-income country, with comparison with an historical control group: an observational study.

Objectives: Rheumatic heart disease (RHD) is a major burden in low-income and middle-income countries (LMICs). Cardiac surgery is the only curative treatment. Little is known about patients with severe chronic RHD operated in LMICs, and challenges regarding postoperative follow-up are an important issue.

Feasibility and Accuracy of Tele-Echocardiography, With Examinations by Nurses and Interpretation by an Expert via Telemedicine, in an Outpatient Heart Failure Clinic.

Objectives: To study the feasibility and accuracy of focused echocardiography by nurses supported by near-real-time interpretation via telemedicine by an experienced cardiologist.

Methods: Fifty consecutive patients were included from an outpatient heart failure (HF) clinic. Limited echocardiography was performed by 1 of 3 specialized nurses.

Patient-reported outcomes and associations with pleural effusion in outpatients with heart failure: an observational cohort study.

Objectives: We aimed to study whether patient-reported outcomes, measured by quality of life (QoL) and functional class, are sensitive to pleural effusion (PLE) in patients with heart failure (HF), and to study changes in QoL and functional class during follow-up of PLE.

Methods: A cohort of 62 patients from an outpatient HF clinic was included. The amount of PLE was quantified using a pocket-sized ultrasound imaging device.

Feasibility and Diagnostic Accuracy of Point-of-Care Abdominal Sonography by Pocket-Sized Imaging Devices, Performed by Medical Residents.

Objectives: We aimed to study the feasibility and diagnostic performance of bedside ultrasound by examination of the liver, gallbladder, kidneys, and abdominal aorta performed by medical residents with limited experience in ultrasound, on emergency admissions using pocket-sized imaging devices (PSIDs).

Methods: A total of 199 patients admitted acutely to the medical department at the non-university Levanger Hospital, Norway, during the period from April 4 to June 23, 2011, were consecutively included. Six medical residents, selected by drawing, examined these patients with a PSID at admission.

Adding point of care ultrasound to assess volume status in heart failure patients in a nurse-led outpatient clinic. A randomised study.

Objectives: Medical history, physical examination and laboratory testing are not optimal for the assessment of volume status in heart failure (HF) patients. We aimed to study the clinical influence of focused ultrasound of the pleural cavities and inferior vena cava (IVC) performed by specialised nurses to assess volume status in HF patients at an outpatient clinic.

Methods: HF outpatients were prospectively included and underwent laboratory testing, history recording and clinical examination by two nurses with and without an ultrasound examination of the pleural cavities and IVC using a pocket-size imaging device, in random order.

Diagnostic influence of routine point-of-care pocket-size ultrasound examinations performed by medical residents.

Objectives: We aimed to investigate the potential benefit of adding goal-directed ultrasound examinations performed by on-call medical residents using a pocket-size imaging device in patients admitted to a medical department.

Methods: A total of 992 emergency admissions to the medical department at a nonuniversity hospital in Norway were included. Patients admitted on dates with an on-call medical resident randomized to use a pocket-size imaging device were eligible for pocket-size cardiac and abdominal ultrasound examinations or standard care.

Focused ultrasound of the pleural cavities and the pericardium by nurses after cardiac surgery.

Objectives: We aimed to study the feasibility and reliability of focused ultrasound (US) examinations to quantify pericardial (PE)- and pleural effusion (PLE) by a pocket-size imaging device (PSID) performed by nurses in patients early after cardiac surgery.

Design: After a 3-month training period, with cardiologists as supervisors, two nurses examined 59 patients (20 women) with US using a PSID at a median of 5 days after cardiac surgery. The amount of PE and PLE was classified in four categories by US (both) and chest x-ray (PLE only).

Feasibility and reliability of pocket-size ultrasound examinations of the pleural cavities and vena cava inferior performed by nurses in an outpatient heart failure clinic.

Background: Routine assessment of volume state by ultrasound may improve follow-up of heart failure patients.

Aims: We aimed to study the feasibility and reliability of focused pocket-size ultrasound examinations of the pleural cavities and the inferior vena cava performed by nurses to assess volume state at an outpatient heart failure clinic.

Methods: Ultrasound examinations were performed in 62 included heart failure patients by specialized nurses with a pocket-size imaging device (PSID).

Blood flow imaging in transesophageal echocardiography during atrial septal defect closure: a comparison with the current references.

Background: Flow visualization before transcatheter atrial septal defect (ASD) closure is essential to identify the number and size of ASDs and to map the pulmonary veins (PV). Previous reports have shown improved visualization of ASD and PV using blood flow imaging (BFI), which supplements color Doppler imaging (CDI) with angle-independent information of flow direction. In this study, we compared transesophageal BFI with the current references in ASD sizing (balloon stretched diameter, BSD) and PV imaging (pulmonary angiography).

Feasibility and reliability of point-of-care pocket-size echocardiography performed by medical residents.

Aims: To study the feasibility and reliability of pocket-size hand-held echocardiography (PHHE) by medical residents with limited experience in ultrasound.

Methods And Results: A total of 199 patients admitted to a non-university medical department were examined with PHHE. Six out of 14 medical residents were randomized to use a focused protocol and examine the heart, pericardium, pleural space, and abdominal large vessels.

Feasibility and clinical implementation of hand-held echocardiography.

Echocardiography is essential in the evaluation of patients with suspected or known cardiovascular disease. The development of pocket-size hand-held echocardiographic devices, suitable for a quick assessment of cardiac structures and function, has been shown to improve diagnostics and patient workflow. In the hands of experts, pocket-size machines capable of gray tone and color flow imaging offer high accuracy for the assessment of ventricular function, the detection of pericardial and pleural effusions and are suitable for semiquantitative evaluation of valvular function.

Routinely adding ultrasound examinations by pocket-sized ultrasound devices improves inpatient diagnostics in a medical department.

Background: We aimed to investigate the potential benefit of adding a routine cardiac and abdominal diagnostic examination by pocket-sized ultrasound device in patients admitted to a medical department.

Methods: A random sample of 196 patients admitted to the medical department at a non-university hospital in Norway between March and September 2010 was studied. The patients underwent cardiac and abdominal screening with a pocket-sized ultrasound device with B-mode and color flow imaging after a principal diagnosis was set.

Aerobic interval training increases peak oxygen uptake more than usual care exercise training in myocardial infarction patients: a randomized controlled study.

Objective: Exercise capacity strongly predicts survival and aerobic interval training (AIT) increases peak oxygen uptake effectively in cardiac patients. Usual care in Norway provides exercise training at the hospitals following myocardial infarction (MI), but the effect and actual intensity of these rehabilitation programmes are unknown.

Design: Randomized controlled trial.

Diagnostic influence of cardiovascular screening by pocket-size ultrasound in a cardiac unit.

Aims: We aimed to study the diagnostic influence of adding a routine cardiovascular ultrasound screening of the cardiac anatomy and function, the pericardium, the pleura and the abdominal great vessels by the new pocket-size ultrasound device (pUS) with grey scale and colour Doppler imaging.

Methods And Results: In 119 randomly selected patients admitted to a cardiac unit at a non-university hospital, routinely adding a cardiovascular ultrasonography of only 4.4 min with a pocket-size device corrected the primary diagnosis in 16% of patients.

Feasibility and reliability of point-of-care pocket-sized echocardiography.

Aims: To study the reliability and feasibility of point-of-care pocket-sized echocardiography (POCKET) at the bedside in patients admitted to a medical department at a non-university hospital.

Methods And Results: One hundred and eight patients were randomized to bedside POCKET examination shortly after admission and later high-end echocardiography (HIGH) in the echo-lab. The POCKET examinations were done by cardiologists on their ward rounds.