{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:52:52Z","timestamp":1790009572370,"version":"4.0.1"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The Prospective Pakistan Registry of Echocardiographic Screening in Asymptomatic Pregnant Women (PRESAP) is a registry designed for the echocardiographic screening of structural heart disease (SHD). It offers a unique opportunity to compare the effectiveness of point-of-care ultrasound (POCUS) vs. routine transthoracic echocardiography (TTE) in this population. This sub-study of the PRESAP registry aimed to compare the detection of SHD in asymptomatic pregnant women using POCUS vs. routine TTE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Between February 2023 and March 2024, pregnant women without known heart disease were enrolled in the PRESAP registry. Participants underwent a limited echocardiogram, using either POCUS or TTE. The primary outcome was the detection of abnormal findings, including left ventricular systolic dysfunction (LVSD), valvular heart disease (VHD), and congenital heart disease (CHD). Matching cohorts were created using propensity score matching, based on demographic factors, comorbid conditions, and gestational history. Among 18 401 patients, 9681 (52.6%) underwent POCUS. The 1:1 propensity-matched cohort included 4177 patients in each arm. Abnormal echocardiographic findings were detected in 4.4% (185) of the TTE group and 3% (124) of the POCUS group (P &amp;lt; 0.001). VHD (1.3% vs. 1.1%; P = 0.416) and CHD (0.4% vs. 0.6%; P = 0.093) were detected at similar rates by both methods, while LVSD was more frequently identified by TTE compared with POCUS (2.8% vs. 1.5%; P &amp;lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>POCUS may be considered as an alternative to TTE for screening for SHD in asymptomatic pregnant women, particularly in resource-limited settings. TTE was superior for LVSD, and POCUS was equally effective in identifying valvular and congenital heart disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjimp\/qyaf110","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:44:54Z","timestamp":1755863094000},"source":"Crossref","is-referenced-by-count":1,"title":["Point-of-care ultrasound vs. routine transthoracic echocardiography for screening of cardiovascular disease in pregnant women"],"prefix":"10.1093","volume":"3","author":[{"given":"Sabha","family":"Bhatti","sequence":"first","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]},{"name":"Department of Cardiology, Rutgers Robert Wood Johnson University Hospital , New Brunswick, NJ 08901 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakeela","family":"Naz","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumyia","family":"Gurmani","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wajid","family":"Hussain","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzma","family":"Atif","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shazia","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"Zahra","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleema","family":"Yasmin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Jinnah Postgraduate Medical Centre (JPMC) , Karachi ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brown University , Providence, RI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musa","family":"Karim","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul","family":"Hakeem","sequence":"additional","affiliation":[{"name":"Department of Adult Cardiology, National Institute of Cardiovascular Diseases (NICVD) , Rafiqui (H.J.) Shaheed Road, Karachi 75510 ,","place":["Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"2025112813012040400_qyaf110-B1","volume-title":"Trends in Maternal Mortality 2000 to 2020: Estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA\/Population Division","author":"World Health Organization","year":"2023"},{"key":"2025112813012040400_qyaf110-B2","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC guidelines for the management of cardiovascular diseases during pregnancy","volume":"39","author":"Regitz-Zagrosek","year":"2018","journal-title":"Eur Heart J"},{"key":"2025112813012040400_qyaf110-B3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.jacc.2019.11.014","article-title":"Peripartum cardiomyopathy: JACC state-of-the-art review","volume":"75","author":"Davis","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2025112813012040400_qyaf110-B4","doi-asserted-by":"crossref","first-page":"2207","DOI":"10.1016\/S0140-6736(12)61999-0","article-title":"Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities","volume":"381","author":"Bhutta","year":"2013","journal-title":"Lancet"},{"key":"2025112813012040400_qyaf110-B5","doi-asserted-by":"crossref","first-page":"101215","DOI":"10.1016\/j.jacadv.2024.101215","article-title":"Prospective Pakistan registry of echocardiographic screening in asymptomatic pregnant women","volume":"3","author":"Bhatti","year":"2024","journal-title":"JACC Adv"},{"key":"2025112813012040400_qyaf110-B6","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.echo.2013.04.001","article-title":"Focused cardiac ultrasound: recommendations from the American Society of Echocardiography","volume":"26","author":"Spencer","year":"2013","journal-title":"J Am Soc Echocardiogr"},{"key":"2025112813012040400_qyaf110-B7","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.7863\/ultra.15.14.09002","article-title":"Cardiac limited ultrasound examination techniques to augment the bedside cardiac physical examination","volume":"34","author":"Kimura","year":"2015","journal-title":"J Ultrasound Med"},{"key":"2025112813012040400_qyaf110-B8","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1161\/CIRCULATIONAHA.114.009029","article-title":"Cardiovascular physiology of pregnancy","volume":"130","author":"Sanghavi","year":"2014","journal-title":"Circulation"},{"key":"2025112813012040400_qyaf110-B9","first-page":"S124","article-title":"The use of cardiac point of care ultrasound (pocus) versus inpatient transthoracic echocardiogram (TTE) in a large tertiary care centre: a comparability and appropriateness study","volume":"40","author":"Ragusa","year":"2024","journal-title":"Can J Cardiol"},{"key":"2025112813012040400_qyaf110-B10","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1002\/clc.23499","article-title":"Point-of-care ultrasound: closing guideline gaps in screening for valvular heart disease","volume":"43","author":"Hammadah","year":"2020","journal-title":"Clin Cardiol"},{"key":"2025112813012040400_qyaf110-B11","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1161\/01.CIR.0000162478.36652.7E","article-title":"Pregnancy-associated cardiomyopathy: clinical characteristics and a comparison between early and late presentation","volume":"111","author":"Elkayam","year":"2005","journal-title":"Circulation"},{"key":"2025112813012040400_qyaf110-B12","first-page":"692","article-title":"Use of routine echocardiographic screening for structural heart disease in at-risk pregnant women in India","volume":"14","author":"Patel","year":"2021","journal-title":"Cardiovascular Imaging"},{"key":"2025112813012040400_qyaf110-B13","doi-asserted-by":"crossref","first-page":"qyae136","DOI":"10.1093\/ehjimp\/qyae136","article-title":"Advancements and applications of artificial intelligence in cardiovascular imaging: a comprehensive review","volume":"2","author":"Fortuni","year":"2024","journal-title":"Eur Heart J Imaging Methods Pract"}],"container-title":["European Heart Journal - 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