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1. Multiple Phenotypes of Chronic Coronary Syndromes Identified by ABCDE Stress Echocardiography

Author

Gaibazzi, Nicola, Ciampi, Quirino, Cortigiani, Lauro, Wierzbowska-Drabik, Karina, Zagatina, Angela, Djordjevic-Dikic, Ana, Manganelli, Fiore, Boshchenko, Alla, Borguezan-Daros, Clarissa, Arbucci, Rosina, Marconi, Sofia, Lowenstein, Jorge, Haberka, Maciej, Celutkiene, Jelena, D’Andrea, Antonello, Rodriguez-Zanella, Hugo, Rigo, Fausto, Monte, Ines, Costantino, Marco Fabio, Ostojic, Miodrag, Merli, Elisa, Pepi, Mauro, Carerj, Scipione, Kasprzak, Jaroslaw D., Pellikka, Patricia A., and Picano, Eugenio

Published
2024
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2. Reversible ischaemia and outcome after adjustment for coronary artery disease severity: a multicentre stress-echocardiography registry.

Author

Gaibazzi, Nicola, Cortigiani, Lauro, Rigo, Fausto, Porter, Thomas R, Guerra, Emiliano, and Ciampi, Quirino

Subjects
MYOCARDIAL infarction, MYOCARDIAL ischemia, CORONARY circulation, HEMODYNAMICS, SEVERITY of illness index, TREATMENT effectiveness, REPORTING of diseases, DIPYRIDAMOLE, MULTIVARIATE analysis, CORONARY arteries, DOPPLER echocardiography, BLOOD flow measurement, RESEARCH, CORONARY artery disease, CORONARY angiography, ECHOCARDIOGRAPHY, PATIENT aftercare, PROPORTIONAL hazards models, REGRESSION analysis
Abstract

Aims To assess the potential association of reversible ischaemia and Doppler coronary flow velocity reserve in the left anterior descending coronary artery (CFVR-LAD) during stress echocardiography (SE) with all-cause mortality and non-fatal myocardial infarction (MI), after correction for anatomic coronary artery disease (CAD) burden and other significant clinical variables. Methods and results We selected 3191 patients (mean age 66 ± 12 years) from our multicentre SE registry, who underwent both high-dose dipyridamole SE (comprehensive of CFVR-LAD measurement) and coronary angiography within 2 months. All-cause mortality and non-fatal MI were the primary end points. The association of the primary end point with ischaemia severity and CFVR-LAD was assessed, after multivariable adjustment for all other significant clinical and imaging variables, including anatomic CAD severity by the modified Duke Prognostic Index. The primary end point occurred in 767 (24%) patients (death in 409 and non-fatal MI in 375 patients) during a median follow-up of 42 months. Multivariable Cox regression analyses indicated that, among other significant variables, anatomic CAD severity, reversible ischaemia, and CFVR-LAD were all independently associated with the primary end point; reversible ischaemia was also associated with subsequent MI, while CFVR-LAD with mortality, independent of anatomic CAD severity. Conclusion Our study suggests that reversible ischaemia by wall motion assessment and CFVR-LAD on dipyridamole SE are independently associated with dismal outcome in patients with suspected or known stable CAD, even after accounting for angiographic anatomic CAD severity and also independently from which coronary artery is diseased. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Functional, Anatomical, and Prognostic Correlates of Coronary Flow Velocity Reserve During Stress Echocardiography

Author

Ciampi, Quirino, Zagatina, Angela, Cortigiani, Lauro, Gaibazzi, Nicola, Borguezan Daros, Clarissa, Zhuravskaya, Nadezhda, Wierzbowska-Drabik, Karina, Kasprzak, Jaroslaw D., de Castro e Silva Pretto, José Luis, D'Andrea, Antonello, Djordjevic-Dikic, Ana, Monte, Ines, Simova, Iana, Boshchenko, Alla, Citro, Rodolfo, Amor, Miguel, Merlo, Pablo Martin, Dodi, Claudio, Rigo, Fausto, Gligorova, Suzana, Dekleva, Milica, Severino, Sergio, Lattanzi, Fabio, Scali, Maria Chiara, Vrublevsky, Alexander, Torres, Marco A.R., Salustri, Alessandro, Rodrìguez-Zanella, Hugo, Costantino, Fabio Marco, Varga, Albert, Bossone, Eduardo, Colonna, Paolo, De Nes, Michele, Paterni, Marco, Carpeggiani, Clara, Lowenstein, Jorge, Gregori, Dario, and Picano, Eugenio

Published
2019
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6. Quality control of regional wall motion analysis in stress Echo 2020

Author

Ciampi, Quirino, Picano, Eugenio, Paterni, Marco, Daros, Clarissa Borguezan, Simova, Iana, de Castro e Silva Pretto, José Luis, Scali, Maria Chiara, Gaibazzi, Nicola, Severino, Sergio, Djordjevic-Dikic, Ana, Kasprzak, Jaroslaw D., Zagatina, Angela, Varga, Albert, Lowenstein, Jorge, Merlo, Pablo Martin, Amor, Miguel, Celutkiene, Jelena, Perez, Julio E., Di Salvo, Giovanni, Galderisi, Maurizio, Mori, Fabio, Costantino, Marco Fabio, Massa, Laura, Dekleva, Milica, Chaves, Daniel Quesada, Trambaiolo, Paolo, Citro, Rodolfo, Colonna, Paolo, Rigo, Fausto, Torres, Marco A.R., Monte, Ines, Stankovic, Ivan, Neskovic, Aleksander, Cortigiani, Lauro, Re, Federica, Dodi, Claudio, D'Andrea, Antonello, Villari, Bruno, Arystan, Ayana, De Nes, Michele, and Carpeggiani, Clara

Published
2017
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7. B-lines with Lung Ultrasound: The Optimal Scan Technique at Rest and During Stress

Author

Picano, Eugenio, Ciampi, Quirino, Citro, Rodolfo, D'Andrea, Antonello, Scali, Maria Chiara, Cortigiani, Lauro, Olivotto, Iacopo, Mori, Fabio, Galderisi, Maurizio, Costantino, Marco Fabio, Pratali, Lorenza, di Salvo, Giovanni, Bossone, Eduardo, Ferrara, Francesco, Kasprszak, Jaroslaw D., Rigo, Fausto, Gaibazzi, Nicola, Limongelli, Giuseppe, Pacileo, Giuseppe, Severino, Sergio, Pinamonti, Bruno, Massa, Laura, Torres, Marco A.R., Miglioranza, Marcelo H., Daros, Clarissa Borguezan, Luis de Castro e Silva Pretto, José, Djordjevic-Dikic, Ana, Dekleva, Milica, Varga, Albert, Agoston, Gergely, Palinkas, Attila, Zagatina, Angela, Simova, Iana, Amor, Miguel, Lowenstein, Jorge, Merlo, Pablo, Celutkiene, Jelena, Perez, Julio E., Trambaiolo, Paolo, Gregori, Dario, Colonna, Paolo, Andreassi, Maria Grazia, De Nes, Michele, Arystan, Ayana, Paterni, Marco, Carpeggiani, Clara, Zhuravskaya, Nadezhda, and Marzilli, Mario

Published
2017
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9. Arterial hypertension in patients with takotsubo syndrome: prevalence, long-term outcome, and secondary preventive strategies: a report from the Takotsubo Italian Network register.

Author

Silverio, Angelo, Bossone, Eduardo, Parodi, Guido, Scudiero, Fernando, Di Maio, Marco, Vriz, Olga, Bellino, Michele, Zito, Concetta, Provenza, Gennaro, Iuliano, Giuseppe, Cristiano, Mario, Novo, Giuseppina, Mauro, Ciro, Rigo, Fausto, Innelli, Pasquale, Salerno-Uriarte, Jorge, Cameli, Matteo, Tremiterra, Giuliana, Vecchione, Carmine, and Antonini-Canterin, Francesco

Published
2023
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10. Prognostic role of stress echocardiography in hypertrophic cardiomyopathy: The International Stress Echo Registry

Author

Ciampi, Quirino, Olivotto, Iacopo, Gardini, Chiara, Mori, Fabio, Peteiro, Jesus, Monserrat, Lorenzo, Fernandez, Xusto, Cortigiani, Lauro, Rigo, Fausto, Lopes, Luis Rocha, Cruz, Ines, Cotrim, Carlos, Losi, Mariangela, Betocchi, Sandro, Beleslin, Branko, Tesic, Milorad, Dikic, Ana Djordjevic, Lazzeroni, Ettore, Lazzeroni, Davide, Sicari, Rosa, and Picano, Eugenio

Published
2016
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16. Association of Coronary Computed Tomography Angiography and Stress Echocardiography with Long-Term Cardiac Outcome: A Comparison Study.

Author

Gaibazzi, Nicola, Rigo, Fausto, Lorenzoni, Valentina, Pasqualetto, Cristina, Foà, Alberto, Cagliari, Enrico, Cavasin, Nicola, Botti, Andrea, Martini, Chiara, and Tuttolomondo, Domenico

Subjects
*STRESS echocardiography, *CORONARY artery calcification, *COMPUTED tomography, *CORONARY artery stenosis, *ANGIOGRAPHY, *MYOCARDIAL infarction
Abstract

Aims: This study aimed to assess which variables on coronary computed tomography angiography (CTA) and vasodilator stress-echocardiography (SE) are best associated with long-term cardiac outcome in patients presenting for suspected chronic coronary syndrome (CCS) who performed both tests. Methods: We identified 397 patients with suspected CCS who, between 2007 and 2019, underwent both SE and CTA within 30 days. Coronary artery calcium score (CACS) and the number of coronary arteries with diameter stenosis >50% were assessed on CTA. The presence of reversible regional wall motion abnormalities (RWMA) and reduced Doppler coronary flow velocity reserve in the left-anterior descending coronary artery (CFVR) were assessed on SE. The association of SE and CTA variables with cardiac outcome (cardiac death or myocardial infarction) was evaluated using Fine and Gray competing risk models. Results: During a median follow-up of 10 years, 38 (9.6%) patients experienced a nonfatal myocardial infarction and 19 (4.8%) died from a cardiac cause. RWMA (HR 7.189, p < 0.001) and a lower CFVR (HR 0.034, p < 0.001) on SE, along with CACS (HR 1.004, p < 0.001) and the number of >50% stenosed coronary vessels (HR 1.975, p < 0.001) on CTA, were each associated with cardiac events. After adjusting for covariates, only CACS and CFVR remained associated (both p < 0.001) with cardiac outcome. Conclusion: Our data suggest that only CFVR on vasodilatory SE and CACS on CTA are independently and strongly associated with long-term cardiac outcome, unlike RWMA or the number of stenosed coronary arteries, usually considered the hallmarks of coronary artery disease on each test. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Beta-blockers are associated with better long-term survival in patients with Takotsubo syndrome.

Author

Silverio, Angelo, Parodi, Guido, Scudiero, Fernando, Bossone, Eduardo, Di Maio, Marco, Vriz, Olga, Bellino, Michele, Zito, Concetta, Provenza, Gennaro, Radano, Ilaria, Baldi, Cesare, D'Andrea, Antonello, Novo, Giuseppina, Mauro, Ciro, Rigo, Fausto, Innelli, Pasquale, Salerno-Uriarte, Jorge, Cameli, Matteo, Vecchione, Carmine, and Canterin, Francesco Antonini

Abstract

Objective: The advantage of beta-blockers has been postulated in patients with Takotsubo syndrome (TTS) given the pathophysiological role of catecholamines. We hypothesised that beta-blocker treatment after discharge may improve the long-term clinical outcome in this patient population.Methods: This was an observational, multicentre study including consecutive patients with TTS diagnosis prospectively enrolled in the Takotsubo Italian Network (TIN) register from January 2007 to December 2018. TTS was diagnosed according to the TIN, Heart Failure Association and InterTAK Diagnostic Criteria. The primary study outcome was the occurrence of all-cause death at the longest available follow-up; secondary outcomes were TTS recurrence, cardiac and non-cardiac death.Results: The study population included 825 patients (median age: 72.0 (63.0-78.0) years; 91.9 % female): 488 (59.2%) were discharged on beta-blockers and 337 (40.8%) without beta-blockers. The median follow-up was 24.0 months. The adjusted Cox regression analysis showed a significantly lower risk for all-cause death (adjusted HR: 0.563; 95% CI: 0.356 to 0.889) and non-cardiac death (adjusted HR: 0.525; 95% CI: 0.309 to 0.893) in patients receiving versus those not receiving beta-blockers, but no significant differences in terms of TTS recurrence (adjusted HR: 0.607; 95% CI: 0.311 to 1.187) and cardiac death (adjusted HR: 0.699; 95% CI: 0.284 to 1.722). The positive survival effect of beta-blockers was higher in patients with hypertension than in those without (pinteraction=0.014), and in patients who developed cardiogenic shock during the acute phase than in those who did not (pinteraction=0.047).Conclusions: In this real-world register population, beta-blockers were associated with a significantly higher long-term survival, particularly in patients with hypertension and in those who developed cardiogenic shock during the acute phase. [ABSTRACT FROM AUTHOR]

Published
2022
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26. Machine Learning Algorithms for Prediction of Survival by Stress Echocardiography in Chronic Coronary Syndromes.

Author

Cortigiani, Lauro, Azzolina, Danila, Ciampi, Quirino, Lorenzoni, Giulia, Gaibazzi, Nicola, Rigo, Fausto, Gherardi, Sonia, Bovenzi, Francesco, Gregori, Dario, and Picano, Eugenio

Subjects
STRESS echocardiography, CORONARY care units, PSYCHOLOGICAL stress, FLOW velocity, CORONARY artery disease, RANDOM forest algorithms, MYOCARDIAL perfusion imaging, MACHINE learning
Abstract

Stress echocardiography (SE) is based on regional wall motion abnormalities and coronary flow velocity reserve (CFVR). Their independent prognostic capabilities could be better studied with a machine learning (ML) approach. The study aims to assess the SE outcome data by conducting an analysis with an ML approach. We included 6881 prospectively recruited and retrospectively analyzed patients with suspected (n = 4279) or known (n = 2602) coronary artery disease submitted to clinically driven dipyridamole SE. The outcome measure was all-cause death. A random forest survival model was implemented to model the survival function according to the patient's characteristics; 1002 patients recruited by a single, independent center formed the external validation cohort. During a median follow-up of 3.4 years (IQR 1.6–7.5), 814 (12%) patients died. The mortality risk was higher for patients aged >60 years, with a resting ejection fraction < 60%, resting WMSI, positive stress-rest WMSI scores, and CFVR < 3.The C-index performance was 0.79 in the internal and 0.81 in the external validation data set. Survival functions for individual patients were easily obtained with an open access web app. An ML approach can be fruitfully applied to outcome data obtained with SE. Survival showed a constantly increasing relationship with a CFVR < 3.0 and stress-rest wall motion score index > Since processing is largely automated, this approach can be easily scaled to larger and more comprehensive data sets to further refine stratification, guide therapy and be ultimately adopted as an open-source online decision tool. [ABSTRACT FROM AUTHOR]

Published
2022
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36. The additional prognostic value of coronary flow reserve on left anterior descending artery in patients with negative stress echo by wall motion criteria: a Transthoracic Vasodilator Stress Echocardiography Study

Author

Rigo, Fausto, Cortigiani, Lauro, Pasanisi, Emilio, Richieri, Margherita, Cutaia, Valeria, Celestre, Massimo, Raviele, Antonio, and Picano, Eugenio

Subjects
Coronary heart disease -- Patient outcomes, Regional blood flow -- Research, Heart ventricle, Left -- Medical examination, Cardiac patients -- Prognosis, Echocardiography -- Evaluation, Health
Published
2006

41. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts)

Author

Perk, Joep, De Backer, Guy, Gohlke, Helmut, Graham, Ian, Reiner, Željko, Verschuren, Monique, Albus, Christian, Benlian, Pascale, Boysen, Gudrun, Cifkova, Renata, Deaton, Christi, Ebrahim, Shah, Fisher, Miles, Germano, Giuseppe, Hobbs, Richard, Hoes, Arno, Karadeniz, Sehnaz, Mezzani, Alessandro, Prescott, Eva, Ryden, Lars, Scherer, Martin, Syvänne, Mikko, Scholte Op Reimer, Wilma J.M., Vrints, Christiaan, Wood, David, Zamorano, Jose Luis, Zannad, Faiez, Cooney, Marie Therese, Bax, Jeroen, Baumgartner, Helmut, Ceconi, Claudio, Dean, Veronica, Deaton, Christi, Fagard, Robert, Funck-Brentano, Christian, Hasdai, David, Hoes, Arno, Kirchhof, Paulus, Knuuti, Juhani, Kolh, Philippe, McDonagh, Theresa, Moulin, Cyril, Popescu, Bogdan A., Reiner, Željko, Sechtem, Udo, Sirnes, Per Anton, Tendera, Michal, Torbicki, Adam, Vahanian, Alec, Windecker, Stephan, Funck-Brentano, Christian, Sirnes, Per Anton, Aboyans, Victor, Ezquerra, Eduardo Alegria, Baigent, Colin, Brotons, Carlos, Burell, Gunilla, Ceriello, Antonio, De Sutter, Johan, Deckers, Jaap, Del Prato, Stefano, Diener, Hans-Christoph, Fitzsimons, Donna, Fras, Zlatko, Hambrecht, Rainer, Jankowski, Piotr, Keil, Ulrich, Kirby, Mike, Larsen, Mogens Lytken, Mancia, Giuseppe, Manolis, Athanasios J., McMurray, John, Pająk, Andrzej, Parkhomenko, Alexander, Rallidis, Loukianos, Rigo, Fausto, Rocha, Evangelista, Ruilope, Luis Miguel, van der Velde, Enno, Vanuzzo, Diego, Viigimaa, Margus, Volpe, Massimo, Wiklund, Olov, and Wolpert, Christian

Published
2012
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46. Prognostic value of stress echocardiography assessed by the ABCDE protocol.

Author

Ciampi, Quirino, Zagatina, Angela, Cortigiani, Lauro, Wierzbowska-Drabik, Karina, Kasprzak, Jaroslaw D, Haberka, Maciej, Djordjevic-Dikic, Ana, Beleslin, Branko, Boshchenko, Alla, Ryabova, Tamara, Gaibazzi, Nicola, Rigo, Fausto, Dodi, Claudio, Simova, Iana, Samardjieva, Martina, Barbieri, Andrea, Morrone, Doralisa, Lorenzoni, Valentina, Prota, Costantina, and Villari, Bruno

Subjects
ECHOCARDIOGRAPHY, CARDIAC imaging, DIAGNOSTIC ultrasonic imaging, HEART disease diagnosis, HEART disease prognosis
Abstract

Aim The aim of this study was to assess the prognostic value of ABCDE-SE in a prospective, large scale, multicentre, international, effectiveness study. Stress echocardiography (SE) was recently upgraded to the ABCDE protocol: step A, regional wall motion abnormalities; step B, B lines; step C, left ventricular contractile reserve; step D, Doppler-based coronary flow velocity reserve in left anterior descending coronary artery; and step E, electrocardiogram-based heart rate reserve. Methods and results From July 2016 to November 2020, we enrolled 3574 all-comers (age 65 ± 11 years, 2070 males, 58%; ejection fraction 60 ± 10%) with known or suspected chronic coronary syndromes referred from 13 certified laboratories. All patients underwent clinically indicated ABCDE-SE. The employed stress modality was exercise (n  = 952, with semi-supine bike, n  = 887, or treadmill, n  = 65 with adenosine for step D) or pharmacological stress (n  = 2622, with vasodilator, n  = 2151; or dobutamine, n  = 471). SE response ranged from score 0 (all steps normal) to score 5 (all steps abnormal). All-cause death was the only endpoint. Rate of abnormal results was 16% for A, 30% for B, 36% for C, 28% for D, and 37% for E steps. During a median follow-up of 21 months (interquartile range: 13–36), 73 deaths occurred. Global X 2 was 49.5 considering clinical variables, 50.7 after step A only (P  = NS (not significant)) and 80.6 after B–E steps (P  < 0.001 vs. step A). Annual mortality rate ranged from 0.4% person-year for score 0 up to 2.7% person-year for score 5. Conclusion ABCDE-SE allows an effective prediction of survival in patients with chronic coronary syndromes. [ABSTRACT FROM AUTHOR]

Published
2021
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