AI-enhanced point-of-care ultrasound detects clinically significant valvular disease in asymptomatic self-referred adults
R Raphael, D Simanovsky, R Loutati, M Sides, R Amster, D A Peleg, D Hochstein, K faierstein, N Sassonker-Joseph, L Fisher, M Fiman, A Amshalom, R Klempfner, E Maor, R BeigelAbstract
Background
Population-based screening studies such as OxVALVE (primary care clinics) and PREVUE-VALVE (pharmacy clients) demonstrated substantial prevalence of asymptomatic valvular heart disease (VHD) in unselected cohorts. We extend these findings to a healthier population of self-referred adults undergoing preventive health screening using AI-enhanced focused cardiac ultrasound (FoCUS) performed by non-physicians.
Purpose
To determine the prevalence of clinically significant VHD in asymptomatic, self-referred adults participating in an annual preventive screening program.
Methods
We evaluated consecutive asymptomatic adults from a self-referred preventive screening program who underwent random AI-enhanced FoCUS assessment. Examinations utilized three standard echocardiographic views (parasternal long/short-axis, apical 4-chamber) with color Doppler evaluation of all valves, performed by trained non-physician healthcare professionals and over-read by two board-certified cardiologists. Clinically significant VHD was defined as moderate-or-greater regurgitation or stenosis per guideline criteria.
Results
Among 1,594 consecutive asymptomatic adults (mean age 65.9 years; 39% women), participants were predominantly healthy, physically active non-smokers with well-controlled risk factors. Comorbidity prevalence was substantially lower than prior studies (hypertension 3% vs. 36% OxVALVE; diabetes 7% vs. 17% PREVUE-VALVE; ischemic heart disease 5%; dyslipidemia 41%). Clinically significant VHD was detected in 3.3% (n=52): mitral regurgitation ≥moderate in 1.6% (n=24), tricuspid regurgitation ≥moderate in 1.2% (n=20), aortic regurgitation moderate in 0.4% (n=7), and severe aortic stenosis in 0.1% (n=1). Indeterminate findings were minimal (1.8%, n=29). Despite the healthier cohort profile, VHD prevalence rates were comparable to those reported in sicker primary care/pharmacy populations.
Conclusions
AI-augmented FoCUS performed by non-physicians identifies clinically significant asymptomatic VHD in 3.3% of self-referred, health-conscious adults with substantially lower comorbidity burden than prior screening cohorts. These findings confirm the persistent burden of subclinical VHD even among highly selected preventive screening populations and support implementation of scalable point-of-care screening to enable early detection and intervention.Table 1- Patient baseline characteristicsTable 1.b - Degree of valvulopathy