Left ventricular geometric abnormality screening in hypertensive patients using a hand-carried ultrasound device

The authors assessed the validity of a hand-carried cardiac ultrasound device operated by an internal medicine resident for left ventricular geometric abnormalities (LVGAs) in mild hypertensive patients. LVGAs were diagnosed when at least one of the following was present: left ventricular mass index exceeding 125 g/m(2) and 110 g/m(2) for men and women, respectively; intraventricular septum thickness > or = 10 mm; posterior wall thickness > or = 10 mm; and left ventricular end-diastolic diameter > or = 5.3 mm. For validation, a cardiologist performed standard echocardiography in all patients. A total of 85 patients completed both echocardiographic studies. LVGAs were diagnosed in 19 (22.4%) cases, 18 of which were confirmed by standard echocardiography. Standard echocardiography did not detect any case of LVGA among the hand-carried cardiac ultrasonography LVGA-negative patients. The sensitivity and specificity of the resident's examination were 100% and 98.78%, respectively. Agreement between the two studies was 99% (kappa 0.97, 95% confidence interval). Hand-carried cardiac ultrasonography may be used as a screening tool for LVGA in hypertensive patients.