The clinical utility of echocardiography as a cardiological diagnostic tool in poor resource settings

Ansa, VO; Odigwe, Clement O; Agbulu, RO; Odudu-Umoh, Idongesit; Uhegbu, V; Ekripko, Udeme

doi:10.4103/1119-3077.106772

Cited by 11 publications

(5 citation statements)

References 11 publications

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“…A high prevalence of cardiomyopathy in our study is closer to the past study by Ghazni et al, which reported the prevalence of cardiomyopathy as high as 45.8% [7]. The reported prevalence of cardiomyopathy in the past studies varies from 9.7% to 45.8% depending on the geography of the population [7][8][9][10].…”

Section: Discussionsupporting

confidence: 84%

Initial Experience of Transthoracic Echocardiography at a Newly Operational Satellite Center in Hyderabad, Pakistan

Balouch¹,

Qamar

Baqai

et al. 2019

Cureus

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IntroductionTransthoracic echocardiography (TTE) is the primary noninvasive imaging modality for quantitative and qualitative evaluation of cardiac anatomy and function. The Hyderabad satellite center of National Institute of Cardiovascular Diseases (NICVD), Pakistan has recently started its operations, including TTE; therefore, it is imperative to assess the initial experience for the process improvement of the center. Therefore, the aim of this clinical audit was to review our initial experience of TTE at this newly operational satellite center.MethodsIn this clinical audit, we reviewed the records of patient undergone TTE at the echocardiography department of NICVD Hyderabad satellite center from May 2018 to October 2018. Demographic characteristics, clinical history, indications for the TTE, and echocardiographic diagnoses were reviewed.ResultsA total of 2,177 TTE procedures were performed during the study period of six months out of which 68.7% (1,496) were performed in male patients. Mean age of the patients was 50.83 ± 12.44 years with 48.2% (1,050) patients above 50 years of age. The most frequent indication for the procedure was cardiomyopathy, 54.1% (1,177), among other indications, native valve regurgitation was in 49.8% (1,085), ischemic heart disease in 23.2% (504), heart murmurs in 17.3% (377), cardiac masses in 14.3% (312), pericardial disease in 8.5% (184), pulmonary disease in 7.3% (160), infective endocarditis in 6.4% (139), aortic and major disease in 6.3% (138), and native valve stenosis in 5.4% (177) of the patients. Procedures were performed before coronary artery revascularization in 2.2% (47) and for prosthetic valve assessment in 1.7% (38) patients. The TTE was normal in 36.6% (796) patients, while the most frequent diagnosis was cardiomyopathy, 53.8% (1,172), among the other TTE findings valvular heart disease was in 21.8% (475), ischemic heart disease (IHD) in 21.6% (470), pericardial disease in 8.0% (175), and congenital heart disease (CHD) in 1.4% (30) patients.ConclusionThis clinical audit showed the effective use of TTE as a noninvasive imaging modality for quantitative and qualitative evaluation of cardiac anatomy and function at a newly operational satellite center of a resource-limited country with normal TTE findings in only 36.6% of the patients.

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Section: Discussionsupporting

confidence: 84%

Initial Experience of Transthoracic Echocardiography at a Newly Operational Satellite Center in Hyderabad, Pakistan

Balouch¹,

Qamar

Baqai

et al. 2019

Cureus

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“…In this study, hypertension/HHD was the second most prevalent clinical indication, with a prevalence of 21.72%. This finding is comparable to the prevalence of 32.1% reported by Ejim et al .,[ 29 ] but significantly lower than the values of 42.5%, 52.1%, 76.0%, and 86.0% reported by Ajayi et al, [ 30 ] Adebayo et al, [ 27 ] Ansa et al, [ 31 ] and Kolo et al ., respectively. [ 32 ] The high rate of hypertension/HHD in this study, as well as in other similar series, may be due in part to the disproportionately larger number of hypertensives referred for echocardiography, despite the fact that hypertension is a major risk factor for cardiovascular disease and is still the most common cardiovascular disease in sub-Saharan Africa.…”

Section: Discussionmentioning

confidence: 63%

Indications for Echocardiography and Confirmation Rates of Cardiovascular Diseases: Experience of a Specialist Cardiac Outpatient Clinic in Kumasi, Ghana

Wiafe,

Acheamfour-Akowuah,

Owusu

2023

Annals of African Medicine

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Background: Transthoracic echocardiography is a very helpful noninvasive cardiovascular imaging technique for the diagnosis and risk stratification in the management of patients with cardiovascular diseases. We aimed to review the clinical indications for transthoracic echocardiography and the confirmation rate of cardiovascular diseases by echocardiography at a specialist cardiac clinic in Ghana. Methods: Using a cross-sectional study design, the echocardiography reports of all patients above the age of 15 who were assessed at the clinic were analyzed. Data on patient demographics, clinical history, clinical indication for echocardiography, and the echocardiographic findings were analyzed using version 25.0 of the Statistical Package for Social Sciences (SPSS). Results: A total of 594 participants were studied. The age range of participants was 15–96 years, with a mean (± standard deviation) age of 53.72 (± 17.25) years. There were more females (50.17%) than males (49.83%). Most (54.21%) of the participants had echocardiography for cardiac evaluation. Other indications included hypertension/hypertensive heart disease (HHD) (n = 131; 22.06%), heart failure (n = 69; 11.62%), chest pains (n = 12; 2.02%), and valvular heart disease (VHD) (n = 11; 1.85%). Three hundred and eight-nine (70.30%) of the participants had their clinical diagnoses confirmed by echocardiography; echocardiographic confirmation rates for heart failure, VHD, and HHD were 92.75%, 90.91%, and 88.54%, respectively. Conclusion: Echocardiography showed high confirmation rates for our patients with heart failure, VHD, and HHD. Prompt usage of this noninvasive cardiovascular imaging for the initial evaluation of patients with cardiovascular diseases is highly recommended.

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“…In addition to representing the current gold standard in diagnosing RHD, TTE is also indispensable for identifying subclinical cases of rheumatic carditis [ 31 , 48 ] by revealing very mild or silent valvular regurgitation [ 49 – 52 ]. Introduction of TTE screening has revealed a higher prevalence of RHD and more advanced disease in several LMICs than previously identified by clinical examinations [ 53 – 55 ]. This highlights the importance of TTE in diagnosing patients suspected to have rheumatic carditis, especially in vulnerable populations.…”

Section: Echocardiography In the Diagnosis Of Rheumatic Carditis And Rhdmentioning

confidence: 99%

Application of Transthoracic Echocardiography for Cardiac Safety Evaluation in the Clinical Development Process of Vaccines Against Streptococcus pyogenes

Nakakana,

Serry-Bangura,

Edem

et al. 2024

Drugs R D

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Superficial infections with Streptococcus pyogenes (Strep A), pharyngitis and impetigo can induce acute rheumatic fever, an autoimmune sequela manifesting mostly with arthritis and rheumatic carditis. Valvular heart damage can persist or advance following repeated episodes of acute rheumatic fever, causing rheumatic heart disease. Acute rheumatic fever and rheumatic heart disease disproportionately affect children and young adults in developing countries and disadvantaged communities in developed countries. People living with rheumatic heart disease are at risk of experiencing potentially fatal complications such as heart failure, bacterial endocarditis or stroke. Transthoracic echocardiography plays a central role in diagnosing both rheumatic carditis and rheumatic heart disease. Despite the obvious medical need, no licensed Strep A vaccines are currently available, as their clinical development process faces several challenges, including concerns for cardiac safety. However, the development of Strep A vaccines has been recently relaunched by many vaccine developers. In this context, a reliable and consistent safety evaluation of Strep A vaccine candidates, including the use of transthoracic echocardiography for detecting cardiac adverse events, could greatly contribute to developing a safe and efficacious product in the near future. Here, we propose a framework for the consistent use of transthoracic echocardiography to proactively detect cardiac safety events in clinical trials of Strep A vaccine candidates. Supplementary Information The online version contains supplementary material available at 10.1007/s40268-024-00452-y.

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The clinical utility of echocardiography as a cardiological diagnostic tool in poor resource settings

Cited by 11 publications

References 11 publications

Initial Experience of Transthoracic Echocardiography at a Newly Operational Satellite Center in Hyderabad, Pakistan

Initial Experience of Transthoracic Echocardiography at a Newly Operational Satellite Center in Hyderabad, Pakistan

Indications for Echocardiography and Confirmation Rates of Cardiovascular Diseases: Experience of a Specialist Cardiac Outpatient Clinic in Kumasi, Ghana

Application of Transthoracic Echocardiography for Cardiac Safety Evaluation in the Clinical Development Process of Vaccines Against Streptococcus pyogenes

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