Arq Bras Cardiol: Imagem cardiovasc. 2024; 37(1): e20230110

Correlation of Telemedicine-guided POCUS Echocardiography and In Situ Data: Pilot Study in a Remote Area in Brazil

Juliane

Rompkoski

, Tarso Augusto Duenhas

Accorsi

, Bruna Dayanne Reges

Amaral

, Christian Barbosa de

Freitas

, Flavio Tocci

Moreira

, Karen Francine

Kohler

, Karine De Amicis

Lima

, Renata Albaladejo

Morbeck

, Carlos Henrique Sartorato

Pedrotti

DOI: 10.36660/abcimg.20230110i

Abstract

Cardiovascular diseases remain the leading cause of mortality in Brazil. Nevertheless, a significant portion of the Brazilian population still faces challenges in accessing specialized care and undergoing complementary exams, especially in remote areas. Currently, data transmission and remote specialized assessment are possible, but obtaining echocardiographic images still relies on a trained professional on-site. This pilot study aimed to assess the feasibility of Point-of-Care Ultrasound (POCUS) tele-echocardiography administered by a general physician with specialist guidance to improve accessibility to cardiovascular exams. Ten patients (mean age was 58.6+8 years, 50% female) from the North region participated, undergoing remote-guided tests using Philips Lumify™ ultrasound and Facetime for transmission. These patients had recent official echocardiographic exams. As part of the POCUS examination, seven echocardiographic views were obtained — parasternal long axis, parasternal short axis (PSAX), apical four chambers (A4C), apical five chambers (A5C), apical two chambers (A2C), subcostal (SC), and suprasternal (SSN). The procedure included linear measurements of cardiac chambers, and valve analysis was performed using color flow. The on-site examinations were carried out by a general physician who underwent brief training prior to the official exams. Despite encountering technical challenges, the study demonstrated the viability of acquiring echocardiographic images. Overall agreement in examination results was observed, except for left ventricular segmental contractility in two cases and the systolic diameter of the left ventricle. The approach, though performed by untrained professionals, showed promise in screening cardiovascular diseases in remote locations, focusing on ventricular function and valvular diseases. Nevertheless, further research is necessary to improve the quality of this process.