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.