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<p>The use of hand-held ultrasound devices (HHUD) is expanding in clinical practice, yet there is limited evidence regarding their role in evaluating transcatheter aortic valve implantation (TAVI). This study assessed the concordance between measurements obtained using an HHUD with continuous wave Doppler (CW) capability and a reference ultrasound system in patients with TAVI prostheses. A prospective, single-centre observational study was conducted in patients with TAVI prostheses. Following a reference echocardiogram by an expert operator, a second blinded evaluation was performed using a HHUD (Kosmos™, EchoNous) with CW Doppler by an intermediate-experience operator. Key valvular parameters were assessed with CW Doppler, and concordance with the reference was evaluated using intraclass correlation coefficient (ICC), linear regression, and Bland-Altman analysis. A total of 64 patients were included after excluding 3 (4.5%) due to measurement difficulties with the HHUD. The mean age was 81 years, with 35.9% being female. Balloon-expandable TAVI accounted for 79,7% of cases, while 20,3% were self-expanding. The HHUD showed good-to-excellent agreement with the reference TTE in the main 4 parameters of valve function: Mean transvalvular gradient (ICC = 0.76), maximum aortic velocity (ICC = 0.83), transvalvular velocity time integral (VTI) (ICC = 0.87) and left ventricle outflow tract VTI (ICC = 0.8). The agreement was good in the remaining echocardiographic measurements. A HHUD with continuous wave Doppler capability showed good concordance with standard echocardiography in patients with TAVI, even when used by operators with intermediate experience.</p> Graphical Abstract <p>Central Illustration: Graphical summary comparing main results of the study. Abbreviations ASE: American society of echocardiography; HHUD = Handheld ultrasound device; ICC = Intraclass correlation coefficient; LVOT: Left ventricle outflow tract; MG: Mean gradient; TV: Transvalvular; Vmax: Maximum velocity; VTI: Velocity time integral. Icons made by Freepik 1,2,3,4 from www.flaticon.com &amp; created with BioRender.com5.</p> <p></p>

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Feasibility and agreement study of a handheld ultrasound device with continuous-wave doppler in transcatheter aortic valve implantation patients

  • 期刊论文

  • 发表日期：

    2026年1月19日

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  • Adrián Margarida de Castro,
  • Jon Zubiaur,
  • Raquel Pérez-Barquín,
  • Manuel Lozano González,
  • Gonzalo Martín Gorría,
  • Luis Javier Ruíz Guerrero,
  • Andrea Teira Calderón,
  • David Serrano Lozano,
  • Gabriela Veiga Fernández,
  • Elton Carreiro Da Cunha,
  • Nuria Gutiérrez Ruiz,
  • Francisco González-Vílchez,
  • José Antonio Vázquez de Prada Tiffe

摘要

The use of hand-held ultrasound devices (HHUD) is expanding in clinical practice, yet there is limited evidence regarding their role in evaluating transcatheter aortic valve implantation (TAVI). This study assessed the concordance between measurements obtained using an HHUD with continuous wave Doppler (CW) capability and a reference ultrasound system in patients with TAVI prostheses. A prospective, single-centre observational study was conducted in patients with TAVI prostheses. Following a reference echocardiogram by an expert operator, a second blinded evaluation was performed using a HHUD (Kosmos™, EchoNous) with CW Doppler by an intermediate-experience operator. Key valvular parameters were assessed with CW Doppler, and concordance with the reference was evaluated using intraclass correlation coefficient (ICC), linear regression, and Bland-Altman analysis. A total of 64 patients were included after excluding 3 (4.5%) due to measurement difficulties with the HHUD. The mean age was 81 years, with 35.9% being female. Balloon-expandable TAVI accounted for 79,7% of cases, while 20,3% were self-expanding. The HHUD showed good-to-excellent agreement with the reference TTE in the main 4 parameters of valve function: Mean transvalvular gradient (ICC = 0.76), maximum aortic velocity (ICC = 0.83), transvalvular velocity time integral (VTI) (ICC = 0.87) and left ventricle outflow tract VTI (ICC = 0.8). The agreement was good in the remaining echocardiographic measurements. A HHUD with continuous wave Doppler capability showed good concordance with standard echocardiography in patients with TAVI, even when used by operators with intermediate experience.

Graphical Abstract

Central Illustration: Graphical summary comparing main results of the study. Abbreviations ASE: American society of echocardiography; HHUD = Handheld ultrasound device; ICC = Intraclass correlation coefficient; LVOT: Left ventricle outflow tract; MG: Mean gradient; TV: Transvalvular; Vmax: Maximum velocity; VTI: Velocity time integral. Icons made by Freepik 1,2,3,4 from www.flaticon.com & created with BioRender.com5.