Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination
Background Degenerative aortic stenosis (AS), the most common valvular heart disease in the Western world, is often diagnosed late when the mortality risk becomes substantial. We determined the feasibility of AS screening during influenza vaccination at general practitioner (GP) surgeries in the UK....
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| Format: | Article |
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BMJ Publishing Group
2021-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001640.full |
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| author | Peter Bramlage Richard Paul Steeds Martin Thoenes Cornelia Deutsch Andrew Potter Navjeet Mangat Maren Fröhlich |
| author_facet | Peter Bramlage Richard Paul Steeds Martin Thoenes Cornelia Deutsch Andrew Potter Navjeet Mangat Maren Fröhlich |
| author_sort | Peter Bramlage |
| collection | DOAJ |
| description | Background Degenerative aortic stenosis (AS), the most common valvular heart disease in the Western world, is often diagnosed late when the mortality risk becomes substantial. We determined the feasibility of AS screening during influenza vaccination at general practitioner (GP) surgeries in the UK.Methods Consecutive subjects aged >65 years presenting to a GP for influenza vaccination underwent heart auscultation and 2D echocardiography (V-scan). Based on these findings, a patient management strategy was determined (referral to cardiologist, review within own practice or no follow-up measures) and status at 3 months was determined.Results 167 patients were enrolled with a mean age of 75 years. On auscultation, a heart murmur was detected in 30 of 167 (18%) patients (6 subjects with an AS-specific and 24 with a non-specific murmur). 75.2% of those with no murmur had a negative V-scan finding. Conversely, 16 of 30 (53%) patients with any murmur had an abnormal V-scan finding that was largely related to the aortic valve. Using clinical auscultation and V-scan screening, a decision not to pursue follow-up measures was taken in 147 (88%) cases, whereas 18 (10.8%) subjects were referred onward; with 5 of 18 (27.8%) and 3 of 18 (16.7%) being diagnosed with mild and moderate AS.Conclusions Our pilot study confirms feasibility of valvular heart disease screening in the elderly in a primary care setting. Using simple and inexpensive diagnostic measures and 7.3 million UK inhabitants undergoing influenza vaccination, nationwide screening could potentially identify 130 000 patients with moderate AS and a significant number of patients with severe AS. |
| format | Article |
| id | doaj-art-2f42d0986d17468cb8b49cadb8b911c9 |
| institution | Kabale University |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-2f42d0986d17468cb8b49cadb8b911c92024-11-11T18:10:08ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2021-001640Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccinationPeter Bramlage0Richard Paul Steeds1Martin Thoenes2Cornelia Deutsch3Andrew Potter4Navjeet Mangat5Maren Fröhlich6Institut für Pharmakologie und Präventive Medizin GmbH, Cloppenburg, GermanyQueen Elizabeth Hospital & Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UKMedical Affairs, Edwards Lifesciences, Nyon, SwitzerlandClinical Studies and Registries, Institute for Pharmacology and Preventive Medicine, Cloppenburg, GermanyWhaddon Medical Centre, Bletchley, UKSwanswell Medical Centre, Birmingham, UKInstitute for Pharmacology and Preventive Medicine, Cloppenburg, GermanyBackground Degenerative aortic stenosis (AS), the most common valvular heart disease in the Western world, is often diagnosed late when the mortality risk becomes substantial. We determined the feasibility of AS screening during influenza vaccination at general practitioner (GP) surgeries in the UK.Methods Consecutive subjects aged >65 years presenting to a GP for influenza vaccination underwent heart auscultation and 2D echocardiography (V-scan). Based on these findings, a patient management strategy was determined (referral to cardiologist, review within own practice or no follow-up measures) and status at 3 months was determined.Results 167 patients were enrolled with a mean age of 75 years. On auscultation, a heart murmur was detected in 30 of 167 (18%) patients (6 subjects with an AS-specific and 24 with a non-specific murmur). 75.2% of those with no murmur had a negative V-scan finding. Conversely, 16 of 30 (53%) patients with any murmur had an abnormal V-scan finding that was largely related to the aortic valve. Using clinical auscultation and V-scan screening, a decision not to pursue follow-up measures was taken in 147 (88%) cases, whereas 18 (10.8%) subjects were referred onward; with 5 of 18 (27.8%) and 3 of 18 (16.7%) being diagnosed with mild and moderate AS.Conclusions Our pilot study confirms feasibility of valvular heart disease screening in the elderly in a primary care setting. Using simple and inexpensive diagnostic measures and 7.3 million UK inhabitants undergoing influenza vaccination, nationwide screening could potentially identify 130 000 patients with moderate AS and a significant number of patients with severe AS.https://openheart.bmj.com/content/8/1/e001640.full |
| spellingShingle | Peter Bramlage Richard Paul Steeds Martin Thoenes Cornelia Deutsch Andrew Potter Navjeet Mangat Maren Fröhlich Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination Open Heart |
| title | Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination |
| title_full | Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination |
| title_fullStr | Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination |
| title_full_unstemmed | Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination |
| title_short | Community-based aortic stenosis detection: clinical and echocardiographic screening during influenza vaccination |
| title_sort | community based aortic stenosis detection clinical and echocardiographic screening during influenza vaccination |
| url | https://openheart.bmj.com/content/8/1/e001640.full |
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