Routinely giving everyone echocardiograms to spot dangerous heart abnormalities would not lower the number of heart attacks, strokes or death, a new study suggests.
The research included more than 3 200 middle-aged people who underwent echocardiograms and a control group of more than 3 500 who did not. In the screening group, 7.6% of the participants underwent follow-up tests and were diagnosed with what doctors call "structural heart disease".
During 15 years of follow-up, about 27% of the people in the screening group and 27.6% of those in the control group died – not a significant difference. There were also no significant differences between the two groups in terms of death from heart disease, sudden death, or rates of fatal or nonfatal heart attack and stroke.
The study was published online July 22 in the journal JAMA Internal Medicine.
Not for everyone
The findings support existing expert guidelines that echocardiography is not recommended for adults in the general population with no symptoms of heart disease, say the team, which was led by Dr Haakon Lindekleiv of the University of Tromso in Norway.
However, echocardiograms are recommended for people who have no symptoms of heart disease but do have a family history of sudden death or hereditary diseases affecting the heart, the study authors added.
Two US heart experts agreed with that assessment.
"The finding strongly supports the guidelines for routine echocardiography stating that routine testing is not recommended for screening low-risk populations and does not reduce risk of death, heart attack and stroke," said Dr Kevin Marzo, chief of cardiology at Winthrop University Hospital in Mineola, NY
Cardiologist Dr Tara Narula concurred that a routine echocardiogram, while safe and easy to use, "is not appropriate for everyone".
For people at low risk of heart disease, "there may be more harm done by increasing patient fear over non-significant lesions [as well as the] added expenses of additional tests when finding mild changes," she said.
Also, if patients get an "all clear" from their echocardiogram, they may take that as license to ignore guidelines for heart-healthy living, said Narula, who is associate director of the cardiac care unit at Lenox Hill Hospital in New York City.
"Until more research is done, the current data supports echocardiography screening only in individuals with a family history of sudden death or genetic cardiac diseases," she said.
The US Centers for Disease Control and Prevention has more about heart disease.