Key result
Handheld cardiac ultrasound screening detects significant VHD in ~4% of seniors.
Why the study?
Valvular heart disease remains underrecognized despite its growing clinical and public health impact, and population-based screening strategies for early detection remain limited.
Does a community-based screening program using hand-held cardiac ultrasound with an automatic referral pathway improve the detection and management of significant valvular heart disease in individuals aged ≥65 years without known cardiovascular disease?
Observational (n=2,777)
Yes
Does a community-based screening program using hand-held cardiac ultrasound with an automatic referral pathway improve the detection and management of significant valvular heart disease in individuals aged ≥65 years without known cardiovascular disease?
A community-based handheld cardiac ultrasound screening program coupled with an automatic specialist referral pathway feasibly detects undiagnosed significant valvular heart disease in 3.8% of older adults, facilitating timely valvular interventions.
Supports feasibility of community HCU screening for undiagnosed VHD in older adults; leaves open whether systematic programs improve outcomes or warrant adoption.
Background Valvular heart disease (VHD) remains underrecognized despite its growing clinical and public health impact. Early detection improves adherence to guidelines and clinical outcomes, yet population-based screening strategies remain limited. Our Mobile Screening Program (MSP) was developed to provide community-based VHD screening using hand-held cardiac ultrasound (HCU) and an automatic referral pathway for comprehensive transthoracic echocardiography (TTE) and specialist evaluation. Methods The MSP targeted individuals aged ≥65 years with no known cardiovascular disease. Participants with suspected VHD using HCU were automatically referred for comprehensive TTE and assessment by a VHD specialist. Significant VHD was defined as mild or greater valvular stenosis, moderate or greater valvular regurgitation, bicuspid aortic valve disease, or valvular masses. Results Between May 2023 and April 2025, we screened 2,777 participants (75±6 years, 69% women) across 104 different community locations in Ontario. Using HCU, VHD was suspected in 151 individuals (5%). Of these, 141 (93%) underwent comprehensive TTE evaluation which confirmed significant VHD in 105 participants (74%), corresponding to a population prevalence of 3.8%. During a median follow-up of five months, 10 participants (7%) had or developed an indication for valvular intervention, which was ultimately performed in all but one individual. Conclusions A community-based HCU screening program with an embedded automatic referral pathway to a VHD clinic is feasible and enables early detection and management of VHD. This model addresses existing access barriers, identifies clinically meaningful diseases, and supports broader implementation of population-level screening strategies to improve cardiovascular outcomes.Central figure
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Dupuy et al. (2026) conducted an observational in Valvular heart disease (n=2,777). Community-based screening using hand-held cardiac ultrasound (HCU) with automatic referral for comprehensive TTE was evaluated on Confirmed significant valvular heart disease (mild or greater stenosis, moderate or greater regurgitation, bicuspid aortic valve, or valvular masses). Community-based handheld cardiac ultrasound screening detected suspected VHD in 5% of seniors and confirmed significant VHD in 3.8% (105/2,777), leading to intervention in 9 patients.
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