BACKGROUND Pediatric heart transplant patients (PedHtx) require frequent monitoring by echocardiography (echo); however, they often live far from hospitals with pediatric echo services, resulting in urgent/emergent transfers to specialized institutions. Our primary objective was to evaluate the feasibility of parental acquisition of echo images to assess left ventricular (LV) systolic function in PedHtx using a handheld echo device. Secondary objectives included retesting for skill maintenance and in patients with decreased LV systolic function. METHODS During a routine clinic visit, parents received 1-hour training with a handheld echo device to acquire images in parasternal short-axis and apical views. Parents recorded images on their children at training completion and 24 hours later at home. An independent echocardiographer assessed clinic, training, and home echos for LV systolic function. RESULTS Fifteen PedHtx (mean age of 12.6 years of age; range, 4.1-16.7) were enrolled. All parents could acquire home images adequate for qualitative assessment of LV systolic function with no discrepancy compared with clinical echos. LV ejection fraction (LVEF) could be calculated (5/6 area-length method) in 86% of training and 43% of home echos with <10% difference in LVEF measurements between home and clinic echos. Five parents repeated home echos >12 months later. All home echos were adequate for qualitative assessment of LV systolic function (LVEF measurable in two). Additionally, five heart failure patients with decreased LV systolic function (mean age of 8.6 years; range 1.9-15.1) were enrolled. All home echos were adequate for qualitative assessment of LV systolic function (LVEF measurable in one). CONCLUSIONS Our results suggest that parental home echo acquisition using a handheld echo device is feasible and adequate for qualitative assessment of LV systolic function in PedHtx. However, quantitative assessment of LV systolic function, especially in patients with dysfunction, and retention of the skill set without additional training are suboptimal.

中文翻译：

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使用手持设备在小儿心脏移植患者中获取父母的超声心动图图像：一项远程医疗研究。

背景技术小儿心脏移植患者（PedHtx）需要通过超声心动图（回声）进行频繁监测。但是，他们经常远离提供小儿回声服务的医院，导致紧急/紧急情况下转移到专门机构。我们的主要目的是评估家长获取回声图像以评估使用手持式回声设备在PedHtx中的左心室（LV）收缩功能的可行性。次要目标包括对技能维持和左室收缩功能降低的患者进行重新测试。方法在例行常规门诊期间，父母使用手持式回声设备接受了1小时的培训，以获取胸骨旁短轴和心尖视图的图像。父母在训练结束时和24小时后在家中将图像记录在自己的孩子身上。独立的超声心动图医师评估的诊所，训练和LV收缩功能的家庭回声。结果招募了十五名PedHtx（平均年龄为12.6岁；范围为4.1-16.7）。与临床回声相比，所有父母都能获得足以定性评估左室收缩功能的家庭影像。可以在86％的训练和43％的家庭回声中计算出LV射血分数（LVEF）（5/6面积长度法），家庭和临床回声之间的LVEF测量值差异小于10％。五个月的父母在> 12个月后重复了家庭回声。所有的家庭回声都足以定性评估LV的收缩功能（LVEF可以一分为二）。此外，还纳入了5名左室收缩功能下降（平均年龄8.6岁；范围1.9-15.1）的心力衰竭患者。所有的家庭回声都足以定性评估左室收缩功能（可测量的LVEF）。结论我们的结果表明，使用手持式回声设备进行父母家庭回声采集是可行的，并且足以定性评估PedHtx中的LV收缩功能。但是，对LV收缩功能（尤其是功能障碍的患者）进行定量评估以及在不进行额外培训的情况下保留技能组的方法不是最佳的。