[Diagnostic usefulness of pocket echography performed in hypertensive patients by a general practitioner]

Abstract

Background and objective: Conventional echocardiography is the technique of choice for assessing cardiac involvement in arterial hypertension. Nevertheless, its availability in primary care is very limited. This study aimed to define the diagnostic usefulness of pocket echocardiography performed by a general practitioner (GP) in patients with arterial hypertension.

Patients and method: Cross-sectional study of a random sample of 393 patients with arterial hypertension. A GP appropriately trained in the technique performed an examination with a pocket echocardiograph and semiquantitatively assessed the different findings. The studies were blindly re-assessed by an expert cardiologist and analyzed quantitatively by computer software. Dimensions of the left ventricle, left atrium and ascending aorta were assessed, together with interventricular septum thickness and presence of valve lesions.

Results: The study took less than 5min and the quality was good-acceptable in 98%. Analysis showed very good concordance (weighted kappa>0,83) in dimensions of the left ventricle, left atrium and ascending aorta, interventricular septum thickness, aortic regurgitation and aortic valve sclerosis, and good concordance (weighted kappa>0,71) in mitral regurgitation and mitral valve calcification. Only 6 (2.6%) of the significant lesions were diagnosed by the GP.

Conclusions: Pocket echocardiography in primary care performed by a GP, as an extension of the clinical assessment of patients with arterial hypertension, provides an early diagnosis of significant cardiac lesions which may improve therapeutic management.