Does Routine Echocardiographic Screening Reduce Mortality?

"The outcomes candidly are a bit of a surprise. The bottom line is, there is absolutely no difference in outcome concerning mortality or incidence of cardiac issues – myocardial infarction or stroke," said Peter Block, MD, FACC.

Routine echocardiographic screening of the general population for structural abnormalities and valvular heart conditions does not reduce mortality, or the risk of stroke or myocardial infarction (MI), according to new findings published July 22 in JAMA: Internal Medicine.

The study analyzed outcomes of 6,861 patients with a mean age of approximately 60 years enrolled in the population-based Tromsø Study in Norway. Patients were randomized to echocardiographic screening or a control group and were followed for the incidence of death, MI or stroke for 15 years. During the follow-up period, results showed the mortality rates for the screening and control groups were 26.9 percent and 27.6 percent, respectively, (hazard ratio, 0.97; 95 percent CI, 0.89-1.06) a difference that did not achieve statistical significance. There also were no statistically significant differences in the secondary outcomes of sudden death, MI or stroke.

 

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"We did not find that early diagnosis of valvular disease in the general population translated into reduced risk of death or cardiovascular events," wrote the investigators. "This supports existing guidelines that echocardiography is not recommended for cardiovascular risk assessment in asymptomatic adults," they add.

The authors conclude that "the importance of our findings is that they add empirical evidence to a recommendation based on an expert consensus opinion. Although our results were negative, we believe that they are of clinical importance because they may contribute to reducing the overuse of echocardiography."


Clinical Topics: Arrhythmias and Clinical EP, Noninvasive Imaging, SCD/Ventricular Arrhythmias, Echocardiography/Ultrasound

Keywords: Incidence, Myocardial Infarction, Stroke, Follow-Up Studies, Norway, Early Diagnosis, Risk Assessment, Death, Sudden, Cardiac, Echocardiography


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