Am J Cardiovasc Dis 2011;1(2):119-125
Original Article
Point-of-care screening for left ventricular hypertrophy and concentric
geometry using hand-held cardiac ultrasound in hypertensive patients
Roxana Stoica, Eliot N. Heller, Jonathan N. Bella
Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center and Albert Einstein College of Medicine,
Bronx, NY, USA
Received June 3, 2011; Accepted June 25, 2011; Epub June 28, 2011; published August 15, 2011
Abstract: Background: The introduction of the hand-held cardiac ultrasound (HCU) may potentially increase detection of
LV hypertrophy in hypertensive patients. However, whether point-of-care screening for LV hypertrophy and concentric LV
geometry by HCU in hypertensive patients is feasible and comparable to that of standard state-of-the-art echocardiography
(SE) evaluation remains to be elucidated. Methods and Results: Accordingly, one hundred consecutive patients (66 female,
mean age=58±13 years, 32% African-American, mean body mass index=31±8 kg/m2) with the diagnosis of hypertension
underwent both HCU and SE examinations in tandem. A cardiology fellow-in-training performed the HCU exam while a
cardiac sonographer performed the SE. 37% of hypertensive patients had electrocardiographic LV hypertrophy by Sokolow-
Lyon or Cornell voltage criteria. Mean LV mass was 210±42 g with the HCU and 209±40 g with SE. Mean relative wall
thickness was 0.45±0.05 by the HCUD and 0.44±0.05 by SE. There was excellent correlation between LV mass and
relative wall thickness measurements by HCU and SE (r=0.985, SEE=6.8 g and r=0.762, SEE=0.33, respectively, both p<0.
001). The prevalence of LV hypertrophy using prognostically-validated partition values for LV mass/height2.7 of 46.7 and
49.2 g/m2.7 in women and men, respectively was 76% by HCU and 78% by SE (p=NS), with excellent agreement (92%,
κ=0.774, p<0.001). Agreement for detection of concentric LV geometry (relative wall thickness>0.43) was also excellent
(88%, κ =0.756, p<0.001). Agreement for LV hypertrophy and concentric geometry detection between the cardiology fellow-
in-training and sonographer was excellent (κ =0.786, p<0.001). Conclusion: Point-of-care screening for LV hypertrophy
and concentric LV geometry by HCU is feasible and correlates very well with that of SE. HCU may allow for immediate
point-of-care assessment and treatment of cardiac target organ damage in hypertensive patients.(AJCD1106001).
Keywords: Echocardiography, left ventricle, hypertension
Full Text PDF
Address all correspondence to:
Jonathan N. Bella, MD
Bronx-Lebanon Hospital Center
Division of Cardiology, 12th Floor
1650 Grand Concourse
Bronx, N.Y. 10457
Phone: (718) 518-5346 Fax: (718) 518-5585
E-mail: jonnbella@earthlink.net
Original Article
Point-of-care screening for left ventricular hypertrophy and concentric
geometry using hand-held cardiac ultrasound in hypertensive patients
Roxana Stoica, Eliot N. Heller, Jonathan N. Bella
Division of Cardiology, Department of Medicine, Bronx-Lebanon Hospital Center and Albert Einstein College of Medicine,
Bronx, NY, USA
Received June 3, 2011; Accepted June 25, 2011; Epub June 28, 2011; published August 15, 2011
Abstract: Background: The introduction of the hand-held cardiac ultrasound (HCU) may potentially increase detection of
LV hypertrophy in hypertensive patients. However, whether point-of-care screening for LV hypertrophy and concentric LV
geometry by HCU in hypertensive patients is feasible and comparable to that of standard state-of-the-art echocardiography
(SE) evaluation remains to be elucidated. Methods and Results: Accordingly, one hundred consecutive patients (66 female,
mean age=58±13 years, 32% African-American, mean body mass index=31±8 kg/m2) with the diagnosis of hypertension
underwent both HCU and SE examinations in tandem. A cardiology fellow-in-training performed the HCU exam while a
cardiac sonographer performed the SE. 37% of hypertensive patients had electrocardiographic LV hypertrophy by Sokolow-
Lyon or Cornell voltage criteria. Mean LV mass was 210±42 g with the HCU and 209±40 g with SE. Mean relative wall
thickness was 0.45±0.05 by the HCUD and 0.44±0.05 by SE. There was excellent correlation between LV mass and
relative wall thickness measurements by HCU and SE (r=0.985, SEE=6.8 g and r=0.762, SEE=0.33, respectively, both p<0.
001). The prevalence of LV hypertrophy using prognostically-validated partition values for LV mass/height2.7 of 46.7 and
49.2 g/m2.7 in women and men, respectively was 76% by HCU and 78% by SE (p=NS), with excellent agreement (92%,
κ=0.774, p<0.001). Agreement for detection of concentric LV geometry (relative wall thickness>0.43) was also excellent
(88%, κ =0.756, p<0.001). Agreement for LV hypertrophy and concentric geometry detection between the cardiology fellow-
in-training and sonographer was excellent (κ =0.786, p<0.001). Conclusion: Point-of-care screening for LV hypertrophy
and concentric LV geometry by HCU is feasible and correlates very well with that of SE. HCU may allow for immediate
point-of-care assessment and treatment of cardiac target organ damage in hypertensive patients.(AJCD1106001).
Keywords: Echocardiography, left ventricle, hypertension
Full Text PDF
Address all correspondence to:
Jonathan N. Bella, MD
Bronx-Lebanon Hospital Center
Division of Cardiology, 12th Floor
1650 Grand Concourse
Bronx, N.Y. 10457
Phone: (718) 518-5346 Fax: (718) 518-5585
E-mail: jonnbella@earthlink.net
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