HAC (Russian)
RSCI (Russian)
Ulrichsweb (Ulrich’s Periodicals Directory)
Scientific Indexing Services

Examination of a cardiac patient, by using carotid artery ultrasound screening: possibilities of telemedicine

DOI: https://doi.org/10.29296/25877305-2023-04-08

K. Arzamasov(1), Candidate of Medical Sciences; V. Bushuev(2), Candidate of Medical Sciences; A. Vladzymyrskyy(1), Dr. Sci. (Med); K. Kozaeva(3); V. Kondratyeva(3);
E. Kostenko(1); D. Leonov(1),4; O. Omelyanskaya(1); R. Reshetnikov(1), Candidate of Physical and Mathematical Sciences; Yu. Shumskaya(1, 5); E. Sorokina(3);
A. Tyazhelnikov(3)
1-Research and Practical Clinical Center for Diagnosis and Telemedicine Technologies, Moscow City Healthcare Department
2-Molecular Diagnosis Center, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow
3-Consultative and Diagnostic Polyclinic One Hundred and Twenty-One, Moscow City Healthcare Department
4-National Research University “Moscow Power Engineering Institute”, Moscow, Russia
5I-.M. Sechenov First Moscow State Medical University (Sechenov University)

In clinical practice, there is a high workload of ultrasound (US) diagnostic rooms and a long waiting time for patients to be examined. For targeted selection of patients for expert US, it is possible for clinicians to conduct focus studies according to short protocols, which can be implemented using extramobile US devices. Objective. To assess the possibility of using telemedicine technologies to train cardiologists in an US-assisted primary examination of patients at an outpatient stage, as well as to evaluate the quality of this US by expert doctors. Material and methods. After briefly learning how to use a Philips Lumify handheld US device, two cardiologists independently examined the carotid arteries of patients, made conclusions about the presence of atherosclerotic plaques, and recorded the time spent on the examination. After each examination, the physician sent a video loop to an US expert, who assessed the quality of scanning. Results. The investigation enrolled 104 patients. The opinion of a cardiologist on the presence of an atherosclerotic plaque coincided with that of the expert in 66% of cases. The physicians spent an average of

carotid artery atherosclerosis
focal US

  1. Evangelista A. et al. Hand-held cardiac ultrasound screening performed by family doctors with remote expert support interpretation. Heart. 2016; 102 (5): 376–82. DOI: 10.1136/heartjnl-2015-308421
  2. Chamsi-Pasha M.A., Sengupta P.P., Zoghbi W.A. Handheld Echocardiography: Current State and Future Perspectives. Circulation. 2017; 136 (22): 2178–88. DOI: 10.1161/CIRCULATIONAHA.117.026622
  3. Gustafsson M., Alehagen U., Johansson P. Imaging Congestion with a Pocket Ultrasound Device: Prognostic Implications in Patients with Chronic Heart Failure. J Card Fail. 2015; 21 (7): 548–54. DOI: 10.1016/j.cardfail.2015.02.004
  4. Kimura B.J., Gilcrease G.W., Showalter B.K. et al. Diagnostic performance of a pocket-sized ultrasound device for quick-look cardiac imaging. Am J Emerg Med. 2012; 30 (1): 32–6. DOI: 10.1016/j.ajem.2010.07.024
  5. Boman K., Olofsson M., Berggren P. et al. Robot-assisted remote echocardiographic examination and teleconsultation: a randomized comparison of time to diagnosis with standard of care referral approach. JACC Cardiovasc Imaging. 2014; 7 (8): 799–803. DOI: 10.1016/j.jcmg.2014.05.006
  6. Morbach C., Buck T., Rost C. et al. Handheld-BNP Research Network. Point-of-care B-type natriuretic peptide and portable echocardiography for assessment of patients with suspected heart failure in primary care: rationale and design of the three-part Handheld-BNP program and results of the training study. Clin Res Cardiol. 2018; 107 (2): 95–107. DOI: 10.1007/s00392-017-1181-3
  7. Singh S., Bansal M., Maheshwari P. et al. ASE-REWARD Study Investigators. American Society of Echocardiography: Remote Echocardiography with Web-Based Assessments for Referrals at a Distance (ASE-REWARD) Study. J Am Soc Echocardiogr. 2013; 26 (3): 221–33. DOI: 10.1016/j.echo.2012.12.012
  8. Seraphim A., Paschou S.A., Grapsa J. et al. Pocket-Sized Echocardiography Devices: One Stop Shop Service? J Cardiovasc Ultrasound. 2016; 24 (1): 1–6. DOI: 10.4250/jcu.2016.24.1.1
  9. Løkkegaard T., Todsen T., Nayahangan L.J. et al. Point-of-care ultrasound for general practitioners: a systematic needs assessment. Scand J Prim Health Care. 2020; 38 (1): 3–11. DOI: 10.1080/02813432.2020.1711572
  10. Драпкина О.М., Джиоева О.Н. Основы УЗИ-ассистированного осмотра и оценки пациентов, госпитализированных с коронавирусной инфекцией в терапевтический стационар. Учебно-методическое пособие. М.: ФГБУ «НМИЦ ТПМ», РОПНИЗ, 2021; 40 с. [Drapkina O.M., Dzhioeva O.N. Osnovy UZI-assistirovannogo osmotra i otsenki patsientov, gospitalizirovannykh s koronavirusnoi infektsiei v terapevticheskii statsionar. Uchebno-metodicheskoe posobie. M.: FGBU «NMITs TPM», ROPNIZ, 2021; 40 s. (in Russ.)].
  11. Мареев Ю.В., Джиоева О.Н., Зоря О.Т. и др. Фокусное ультразвуковое исследование в практике кардиолога. Российский согласительный документ. Кардиология. 2021; 61 (11): 4–23 [Mareev Yu.V., Dzhioeva O.N., Zorya O.T. et al. Focus ultrasound for cardiology practice. Russian consensus document. Kardiologiia. 2021; 61 (11): 4–23 (in Russ.)]. DOI: 10.18087/cardio.2021.11.n1812
  12. Нарциссова Г.П., Волкова И.И., Зорина И.Г. и др. Алгоритмы ультразвуковой диагностики острых сердечно-сосудистых событий. Сибирский журнал клинической и экспериментальной медицины. 2018; 33 (4): 27–37 [Nartsissova G.P., Volkova I.I., Zorina I.G. et al. Diagnostic ultrasound algorithms for acute cardiovascular events. The Siberian Journal of Clinical and Experimental Medicine. 2018; 33 (4): 27–37 (in Russ.)]. DOI: 10.29001/2073-8552-2018-33-4-27-37
  13. Tolsgaard M.G., Todsen T., Sorensen J.L. et al. International multispecialty consensus on how to evaluate ultrasound competence: a Delphi consensus survey. PLoS One. 2013; 8 (2): e57687. DOI: 10.1371/journal.pone.0057687
  14. Селиверстов П.В., Безручко Д.С., Васин А.В. и др. Телемедицинский дистанционный многопрофильный анкетный скрининг как инструмент раннего выявления хронических неинфекционных заболеваний. Медицинский совет. 2023; 17 (6): (in print.) [Seliverstov P.V., Bezruchko D.S., Vasin A.V. et al. Telemedicine remote multidisciplinary questionnaire screening as a tool for early detection of chronic non-communicable diseases. Meditsinskiy Sovet. 2023; 17 (6): (in print.) (in Russ.)]. DOI: 10.21518/ms2023-070
  15. Touboul P.J. et al. Mannheim Carotid Intima-Media Thickness and Plaque Consensus (2004–2006–2011). Cerebrovasc Dis. 2012; 34: 290–6. DOI: 10.1159/000343145
  16. Hyndman R.J., Khandakar Y. Automatic time series forecasting: the forecast package for R. J Stat Softw. 2008; 27 (3): 1–22. DOI: 10.18637/jss.v027.i03
  17. R Core Team. R: A language and environment for statistical computing. R foundation for statistical computing. Vienna, Austria; 2021.
  18. Hyndman R.J., Athanasopoulos G., Bergmeir C. et al. forecast: Forecasting functions for time series and linear models. Semantic Scholar; 2020.
  19. Шипова В.М. Нормы труда медицинских работников поликлиник: иллюзии и реальность. ГЭОТАР-Медиа, 2018 [Shipova V.M. Normy truda meditsinskikh rabotnikov poliklinik: illyuzii i real'nost'. GEOTAR-Media, 2018 (in Russ.)].
  20. Щербаков Д.В., Нелидова А.В., Усачева Е.В. и др. Динамика и структура заболеваемости ишемической болезнью сердца в Омской области. Современные проблемы науки и образования. 2017; 5: 53 [Scherbakov D.V., Nelidova A.V., Usacheva E.V. et al. Dynamics and structure of morbidity of ischemic heart disease in Omsk region. Modern problems of science and education. 2017; 5: 53 (in Russ.)].
  21. Балахонова Т.В., Погорелова О.А., Трипотень М.И. и др. Сокращенный протокол ультразвукового дуплексного сканирования сонных артерий в оценке доклинического атеросклероза с целью уточнения сердечно-сосудистого риска. Российский кардиологический журнал. 2019; 5: 62–8 [Balakhonova T.V., Pogorelova O.A., Tripoten M.I. et al. Abbreviated protocol for ultrasound duplex scanning of the carotid arteries in the evaluation of preclinical atherosclerosis in order to clarify cardiovascular risk. Russian Journal of Cardiology. 2019; 5: 62–8 (in Russ.)]. DOI: 10.15829/1560-4071-2019-5-62-68
  22. Peters A., Patil P.V. Tele-echocardiography: enhancing quality at the point-of-care. Heart. 2019; 105 (4): 264–5. DOI: 10.1136/heartjnl-2018-313969
  23. Морозов С.П., Владзимирский А.В., Ветшева Н.Н. и др. Референс-центр лучевой диагностики: обоснование и концепция Научно-практического центра медицинской радиологии Департамента здравоохранения г. Москвы. Менеджер здравоохранения. 2019; 8: 25–34 [Morozov S.P., Vladzymyrskyy A.V., Vetsheva N.N. et al. Reference center of radiology: justification and concept. Manager zdravoohranenia. 2019; 8: 25–34 (in Russ.)].
  24. Полищук Н.С., Ветшева Н.Н., Косарин С.П. и др. Единый радиологический информационный сервис как инструмент организационно-методической работы научно-практического центра медицинской радиологии департамента здравоохранения г. Москвы (аналитическая справка). Радиология – практика. 2018; 1: 6–17 [Polishchuk N.S., Vetsheva N.N., Kosarin S.P. et al. Unified Radiological Information Service as a Key Element of Organizational and Methodical Work of Research and Practical Center of Medical Radiology. Radiology – Practice. 2018; 1: 6–17 (in Russ.)]