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J Am Soc Echocardiogr. 2013 Jun;26(6):589-96. doi: 10.1016/j.echo.2013.03.008. Epub 2013 Apr 17.

A novel and simple method using pocket-sized echocardiography to screen for aortic stenosis.

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  • 1Department of Cardiology, Osaka City General Hospital, Osaka, Japan.



Pocket-sized echocardiography may serve as an initial tool to screen for aortic stenosis (AS). The purpose of this study was to evaluate the usefulness of a novel and simple method using pocket-sized echocardiography to screen for AS.


Subjects (n= 130) with systolic ejection murmur or known AS were studied. After physical examination, each aortic cusp's opening was visually scored using pocket-sized echocardiography as follows: 0= not restricted, 1= restricted, or 2= severely restricted. The sum of the scores was defined as the visual AS score. On the basis of high-end echocardiography, an aortic valve area index <0.60 cm(2)/m(2) and an aortic valve area index of 0.60 to 0.85 cm(2)/m(2) were considered to indicate severe and moderate AS, respectively.


For diagnosing severe AS (n= 27), a visual AS score ≥ 4 had sensitivity of 85% and specificity of 89%. For diagnosing moderate to severe AS (n= 57), a visual AS score ≥ 3 had sensitivity of 84% and specificity of 90%. The areas under the receiver operating characteristic curves for diagnosing severe and moderate to severe AS with a visual AS score (0.946 and 0.936, respectively) were slightly larger than those for a skilled physical examination (0.917 and 0.898, respectively) (P= NS for both) but were significantly larger than for an aortic valve calcification score also obtained using pocket-sized echocardiography (areas under the curve, 0.816 [P= .0015] and 0.827 [P= .0001], respectively).


A novel and simple method using pocket-sized echocardiography is useful for rapid grading of AS in subjects with systolic ejection murmur.

Copyright © 2013 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

[PubMed - indexed for MEDLINE]
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