Focused Echocardiography for Primary Care Physicians (UPCOMING)

CLINICAL FEASIBILITY OF ULTRAPORTABLE CARDIAC ULTRASOUND PERFORMED IN THE GENERAL PRACTITIONER'S OFFICE TO IDENTIFY CARDIOVASCULAR ABNORMALITIES

Our society is characterized by a steady improvement in the standard of living of its inhabitants, which is reflected, among other things, in improved healthcare and quality of life (longer life expectancy, lower infant mortality, treatment of chronic diseases, cancer plan). Many factors contribute to this, but technological innovations and therapeutic advances are the main ones. This positive overall picture should not obscure the fact that there are significant regional disparities.

For more than 15 years, the former Lower Normandy region (Calvados, Manche, and Orne), like many other regions in France, has been marked by increasingly complex access to healthcare, whether for primary care or for so-called specialty disciplines. This situation is gradually leading to the creation of medical deserts. There are many reasons for this (numerus clausus, sociological changes, urbanization of young practitioners, attraction of small rural towns by medium-sized cities), which are chronic and have no clearly identified solution.

This situation complicates patient care and, in some cases, represents a major public health challenge, such as in the treatment of heart failure (HF), which affects more than one million people in France, or 2.3% of the adult population. For 2.3 times more deaths each year than strokes and five times more than myocardial infarctions.

Some healthcare innovations can reduce the consequences of these areas of stress. In the field of cardiology, recent initiatives based on the creation of specialized cardiology and telemedicine care teams have been proposed. In primary care, point-of-care solutions enable many tests to be performed on an outpatient basis. Imaging plays a central role in patient care, and ultrasound is often the first-line modality in cardiology. Technological innovations in this field have made it possible to miniaturize ultrasound machines to such an extent that some of them can now be considered POCUS (point-of-care ultrasound). Their reduced manufacturing costs, combined with the maturity of the technique, make it possible to offer simplified acquisition protocols adapted to specific questions, known as targeted clinical ultrasound.

This simplification/miniaturization of ultrasound equipment has facilitated the spread of this technique outside the field of cardiology and now allows for its use by general practitioners close to patients, specifically for screening purposes. Many diseases would benefit from early screening in order to reduce hospitalizations, mortality, and societal costs. In cardiology, this approach remains difficult because the majority of patients admitted to healthcare facilities have already developed the disease. HF is characterized by an initial silent phase which, if left untreated, inevitably leads to complications and death. It is responsible for 200,000 hospitalizations per year in France, causing the deaths of 70,000 people. Certain signs, grouped under the French acronym EPOF, appear early on and can be warning signs, but they are often vague and unfamiliar to the general public. This fact is well illustrated by the results of a survey conducted by the Heart Failure and Cardiomyopathy Group (GICC) of the French Society of Cardiology (SFC) in 2017 (5,000 subjects representative of the French population aged 18 to 80). This survey noted that two-thirds of subjects presenting four of these signs (EPOF) had not consulted a cardiologist in the 12 months prior to the questionnaire. In the majority of cases, these patients, whether asymptomatic or paucisymptomatic (EPOF), have morphological and functional abnormalities of the heart, which are the first step toward more severe complications and can be detected by cardiac echocardiography.

There is currently a favorable alignment between echocardiography as a public health need (early detection of conditions that can lead to heart failure) and frontline practitioners (general practitioners). This alignment could lead to the definition of new practices and a new care pathway. While echocardiography is technically feasible in a general practitioner's office, its implementation remains to be evaluated (HAS report). This report emphasizes the lack of data in the literature to identify use cases and clinical impact in general medicine in France.

Study Overview

• Status: Not yet recruiting
• Conditions: Cough; Weight Gain; Oedema; Dyspnea; Cardiac; Cardiac Risk Factors; Age 65 and Older; Fatigability
• Intervention / Treatment: Device: point of care ultrasound

• Study Type: Interventional
• Enrollment (Estimated): 300
• Phase: Not Applicable

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Men and women aged 65 or older with no cardiac symptoms and presenting with a treated or untreated cardiovascular risk factor (hypertension and/or diabetes and/or dyslipidemia) or

• Adult men and women presenting with one of the following signs:

  • Stage I-II exertional dyspnea
  • Lower limb edema
  • Unexplained fatigue
  • Weight gain
  • Unexplained cough
  • History of carpal tunnel surgery (search for signs of myocardial infiltration by cardiac amyloidosis)

Exclusion Criteria:

• Patients with arrhythmia or ventricular or supraventricular hyper excitability.

• Symptomatic patients:

  • exertional dyspnea (NYHA >2)
  • palpitations
  • malaise
  • chest pain
• Obese individuals with a BMI >35
• Patients with breast implants
• Patients under guardianship, conservatorship, or legal protection
• Patients without health insurance coverage or equivalent
• Patients known to have heart disease
• Patients who have had a cardiology consultation within the last 5 years
• Subjects with known heart disease, whether monitored or not.
• Known valvular heart disease (whether monitored or not)
• Known coronary artery disease (whether monitored or not)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Targeted Echo Group	Device: point of care ultrasound; TargetedClinical Ultrasound exam

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical feasibility of cardiac ultrasound performed in a GP office within the specific framework of the proposed acquisition protocol.	Concordance between the interpretation by the general practitioner and by the expert of the ECC1 examination performed by the general practitioner in his office in the study population	The targeted ultrasound performed by the general practitioner will be reviewed by the specialist within 72 hours.

Collaborators and Investigators

• Sponsor: University Hospital, Caen

Study record dates

Study Major Dates

• Study Start (Estimated): March 1, 2026
• Primary Completion (Estimated): May 31, 2027
• Study Completion (Estimated): May 31, 2027

Study Registration Dates

• First Submitted: September 22, 2025
• First Submitted That Met QC Criteria: February 16, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 16, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Body Weight; Respiratory Tract Diseases; Body Weight Changes; Respiration Disorders; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Weight Gain; Cough; Edema; Dyspnea
• Other Study ID Numbers: 23-0197; 2023-A02068-37 (Registry Identifier: Agence nationale de sécurité du médicament et des produits de santé)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No