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1. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging

Author: Ciampi, Q, Pepi, M, Antonini-Canterin, F, Barbieri, A, Barchitta, A, Faganello, G, Miceli, S, Parato, V, Tota, A, Trocino, G, Abbate, M, Accadia, M, Alemanni, R, Angelini, A, Anglano, F, Anselmi, M, Aquila, I, Aramu, S, Avogadri, E, Azzaro, G, Badano, L, Balducci, A, Ballocca, F, Barbarossa, A, Barbati, G, Barletta, V, Barone, D, Becherini, F, Benfari, G, Beraldi, M, Bergandi, G, Bilardo, G, Binno, S, Bolognesi, M, Bongiovi, S, Bragato, R, Braggion, G, Brancaleoni, R, Bursi, F, Dessalvi, C, Cameli, M, Canu, A, Capitelli, M, Capra, A, Carbonara, R, Carbone, M, Carbonella, M, Carrabba, N, Casavecchia, G, Casula, M, Chesi, E, Cicco, S, Citro, R, Cocchia, R, Colombo, B, Colonna, P, Conte, M, Corrado, G, Cortesi, P, Cortigiani, L, Costantino, M, Cozza, F, Cucchini, U, D'Angelo, M, Ros, S, D'Andrea, F, D'Andrea, A, D'Auria, F, De Caridi, G, De Feo, S, De Matteis, G, De Vecchi, S, Del Giudice, C, Dell'Angela, L, Delli Paoli, L, Dentamaro, I, Destefanis, P, Di Fulvio, M, Di Gaetano, R, Di Giannuario, G, Di Gioia, A, Di Martino, L, Di Muro, C, Di Nora, C, Di Salvo, G, Dodi, C, Dogliani, S, Donati, F, Dottori, M, Epifani, G, Fabiani, I, Ferrara, F, Ferrara, L, Ferrua, S, Filice, G, Fiorino, M, Forno, D, Garini, A, Giarratana, G, Gigantino, G, Giorgi, M, Giubertoni, E, Greco, C, Grigolato, M, Marra, W, Holzl, A, Iaiza, A, Iannaccone, A, Ilardi, F, Imbalzano, E, Inciardi, R, Inserra, C, Iori, E, Izzo, A, La Rosa, G, Labanti, G, Lanzone, A, Lanzoni, L, Lapetina, O, Leiballi, E, Librera, M, Lo Conte, C, Lo Monaco, M, Lombardo, A, Luciani, M, Lusardi, P, Magnante, A, Malagoli, A, Malatesta, G, Mancusi, C, Manes, M, Manganelli, F, Mantovani, F, Manuppelli, V, Marchese, V, Marinacci, L, Mattioli, R, Maurizio, C, Mazza, G, Mazza, S, Melis, M, Meloni, G, Merli, E, Milan, A, Minardi, G, Monaco, A, Monte, I, Montresor, G, Moreo, A, Mori, F, Morini, S, Moro, C, Morrone, D, Negri, F, Nipote, C, Nisi, F, Nocco, S, Novello, L, Nunziata, L, Perini, A, Parodi, A, Pasanisi, E, Pastorini, G, Pavasini, R, Pavoni, D, Pedone, C, Pelliccia, F, Pelliciari, G, Pelloni, E, Pergola, V, Perillo, G, Petruccelli, E, Pezzullo, C, Piacentini, G, Picardi, E, Pinna, G, Pizzarelli, M, Pizzuti, A, Poggi, M, Posteraro, A, Privitera, C, Rampazzo, D, Ratti, C, Rettegno, S, Ricci, F, Ricci, C, Rolando, C, Rossi, S, Rovera, C, Ruggieri, R, Russo, M, Sacchi, N, Saladino, A, Sani, F, Sartori, C, Scarabeo, V, Sciacqua, A, Scillone, A, Scopelliti, P, Scorza, A, Scozzafava, A, Serafini, F, Serra, W, Severino, S, Simeone, B, Sirico, D, Solari, M, Spadaro, G, Stefani, L, Strangio, A, Surace, F, Tamborini, G, Tarquinio, N, Tassone, E, Tavarozzi, I, Tchana, B, Tedesco, G, Tinto, M, Torzillo, D, Totaro, A, Triolo, O, Troisi, F, Tusa, M, Vancheri, F, Varasano, V, Venezia, A, Vermi, A, Villari, B, Zampi, G, Zannoni, J, Zito, C, Zugaro, A, Di Bella, G, Carerj, S, Ciampi Q., Pepi M., Antonini-Canterin F., Barbieri A., Barchitta A., Faganello G., Miceli S., Parato V. M., Tota A., Trocino G., Abbate M., Accadia M., Alemanni R., Angelini A., Anglano F., Anselmi M., Aquila I., Aramu S., Avogadri E., Azzaro G., Badano L., Balducci A., Ballocca F., Barbarossa A., Barbati G., Barletta V., Barone D., Becherini F., Benfari G., Beraldi M., Bergandi G., Bilardo G., Binno S. M., Bolognesi M., Bongiovi S., Bragato R. M., Braggion G., Brancaleoni R., Bursi F., Dessalvi C. C., Cameli M., Canu A., Capitelli M., Capra A. C. M., Carbonara R., Carbone M., Carbonella M., Carrabba N., Casavecchia G., Casula M., Chesi E., Cicco S., Citro R., Cocchia R., Colombo B. M., Colonna P., Conte M., Corrado G., Cortesi P., Cortigiani L., Costantino M. F., Cozza F., Cucchini U., D'Angelo M., Ros S. D., D'Andrea F., D'Andrea A., D'Auria F., De Caridi G., De Feo S., De Matteis G. M., De Vecchi S., Del Giudice C., Dell'Angela L., Delli Paoli L., Dentamaro I., Destefanis P., Di Fulvio M., Di Gaetano R., Di Giannuario G., Di Gioia A., Di Martino L. F. M., Di Muro C., Di Nora C., Di Salvo G., Dodi C., Dogliani S., Donati F., Dottori M., Epifani G., Fabiani I., Ferrara F., Ferrara L., Ferrua S., Filice G., Fiorino M., Forno D., Garini A., Giarratana G. A., Gigantino G., Giorgi M., Giubertoni E., Greco C. A., Grigolato M., Marra W. G., Holzl A., Iaiza A., Iannaccone A., Ilardi F., Imbalzano E., Inciardi R., Inserra C. A., Iori E., Izzo A., La Rosa G., Labanti G., Lanzone A. M., Lanzoni L., Lapetina O., Leiballi E., Librera M., Lo Conte C., Lo Monaco M., Lombardo A., Luciani M., Lusardi P., Magnante A., Malagoli A., Malatesta G., Mancusi C., Manes M. T., Manganelli F., Mantovani F., Manuppelli V., Marchese V., Marinacci L., Mattioli R., Maurizio C., Mazza G. A., Mazza S., Melis M., Meloni G., Merli E., Milan A., Minardi G., Monaco A., Monte I., Montresor G., Moreo A., Mori F., Morini S., Moro C., Morrone D., Negri F., Nipote C., Nisi F., Nocco S., Novello L., Nunziata L., Perini A. P., Parodi A., Pasanisi E. M., Pastorini G., Pavasini R., Pavoni D., Pedone C., Pelliccia F., Pelliciari G., Pelloni E., Pergola V., Perillo G., Petruccelli E., Pezzullo C., Piacentini G., Picardi E., Pinna G., Pizzarelli M., Pizzuti A., Poggi M. M., Posteraro A., Privitera C., Rampazzo D., Ratti C., Rettegno S., Ricci F., Ricci C., Rolando C., Rossi S., Rovera C., Ruggieri R., Russo M. G., Sacchi N., Saladino A., Sani F., Sartori C., Scarabeo V., Sciacqua A., Scillone A., Scopelliti P. A., Scorza A., Scozzafava A., Serafini F., Serra W., Severino S., Simeone B., Sirico D., Solari M., Spadaro G. L., Stefani L., Strangio A., Surace F. C., Tamborini G., Tarquinio N., Tassone E. J., Tavarozzi I., Tchana B., Tedesco G., Tinto M., Torzillo D., Totaro A., Triolo O. F., Troisi F., Tusa M., Vancheri F., Varasano V., Venezia A., Vermi A. C., Villari B., Zampi G., Zannoni J., Zito C., Zugaro A., Di Bella G., Carerj S., Ciampi, Q, Pepi, M, Antonini-Canterin, F, Barbieri, A, Barchitta, A, Faganello, G, Miceli, S, Parato, V, Tota, A, Trocino, G, Abbate, M, Accadia, M, Alemanni, R, Angelini, A, Anglano, F, Anselmi, M, Aquila, I, Aramu, S, Avogadri, E, Azzaro, G, Badano, L, Balducci, A, Ballocca, F, Barbarossa, A, Barbati, G, Barletta, V, Barone, D, Becherini, F, Benfari, G, Beraldi, M, Bergandi, G, Bilardo, G, Binno, S, Bolognesi, M, Bongiovi, S, Bragato, R, Braggion, G, Brancaleoni, R, Bursi, F, Dessalvi, C, Cameli, M, Canu, A, Capitelli, M, Capra, A, Carbonara, R, Carbone, M, Carbonella, M, Carrabba, N, Casavecchia, G, Casula, M, Chesi, E, Cicco, S, Citro, R, Cocchia, R, Colombo, B, Colonna, P, Conte, M, Corrado, G, Cortesi, P, Cortigiani, L, Costantino, M, Cozza, F, Cucchini, U, D'Angelo, M, Ros, S, D'Andrea, F, D'Andrea, A, D'Auria, F, De Caridi, G, De Feo, S, De Matteis, G, De Vecchi, S, Del Giudice, C, Dell'Angela, L, Delli Paoli, L, Dentamaro, I, Destefanis, P, Di Fulvio, M, Di Gaetano, R, Di Giannuario, G, Di Gioia, A, Di Martino, L, Di Muro, C, Di Nora, C, Di Salvo, G, Dodi, C, Dogliani, S, Donati, F, Dottori, M, Epifani, G, Fabiani, I, Ferrara, F, Ferrara, L, Ferrua, S, Filice, G, Fiorino, M, Forno, D, Garini, A, Giarratana, G, Gigantino, G, Giorgi, M, Giubertoni, E, Greco, C, Grigolato, M, Marra, W, Holzl, A, Iaiza, A, Iannaccone, A, Ilardi, F, Imbalzano, E, Inciardi, R, Inserra, C, Iori, E, Izzo, A, La Rosa, G, Labanti, G, Lanzone, A, Lanzoni, L, Lapetina, O, Leiballi, E, Librera, M, Lo Conte, C, Lo Monaco, M, Lombardo, A, Luciani, M, Lusardi, P, Magnante, A, Malagoli, A, Malatesta, G, Mancusi, C, Manes, M, Manganelli, F, Mantovani, F, Manuppelli, V, Marchese, V, Marinacci, L, Mattioli, R, Maurizio, C, Mazza, G, Mazza, S, Melis, M, Meloni, G, Merli, E, Milan, A, Minardi, G, Monaco, A, Monte, I, Montresor, G, Moreo, A, Mori, F, Morini, S, Moro, C, Morrone, D, Negri, F, Nipote, C, Nisi, F, Nocco, S, Novello, L, Nunziata, L, Perini, A, Parodi, A, Pasanisi, E, Pastorini, G, Pavasini, R, Pavoni, D, Pedone, C, Pelliccia, F, Pelliciari, G, Pelloni, E, Pergola, V, Perillo, G, Petruccelli, E, Pezzullo, C, Piacentini, G, Picardi, E, Pinna, G, Pizzarelli, M, Pizzuti, A, Poggi, M, Posteraro, A, Privitera, C, Rampazzo, D, Ratti, C, Rettegno, S, Ricci, F, Ricci, C, Rolando, C, Rossi, S, Rovera, C, Ruggieri, R, Russo, M, Sacchi, N, Saladino, A, Sani, F, Sartori, C, Scarabeo, V, Sciacqua, A, Scillone, A, Scopelliti, P, Scorza, A, Scozzafava, A, Serafini, F, Serra, W, Severino, S, Simeone, B, Sirico, D, Solari, M, Spadaro, G, Stefani, L, Strangio, A, Surace, F, Tamborini, G, Tarquinio, N, Tassone, E, Tavarozzi, I, Tchana, B, Tedesco, G, Tinto, M, Torzillo, D, Totaro, A, Triolo, O, Troisi, F, Tusa, M, Vancheri, F, Varasano, V, Venezia, A, Vermi, A, Villari, B, Zampi, G, Zannoni, J, Zito, C, Zugaro, A, Di Bella, G, Carerj, S, Ciampi Q., Pepi M., Antonini-Canterin F., Barbieri A., Barchitta A., Faganello G., Miceli S., Parato V. M., Tota A., Trocino G., Abbate M., Accadia M., Alemanni R., Angelini A., Anglano F., Anselmi M., Aquila I., Aramu S., Avogadri E., Azzaro G., Badano L., Balducci A., Ballocca F., Barbarossa A., Barbati G., Barletta V., Barone D., Becherini F., Benfari G., Beraldi M., Bergandi G., Bilardo G., Binno S. M., Bolognesi M., Bongiovi S., Bragato R. M., Braggion G., Brancaleoni R., Bursi F., Dessalvi C. C., Cameli M., Canu A., Capitelli M., Capra A. C. M., Carbonara R., Carbone M., Carbonella M., Carrabba N., Casavecchia G., Casula M., Chesi E., Cicco S., Citro R., Cocchia R., Colombo B. M., Colonna P., Conte M., Corrado G., Cortesi P., Cortigiani L., Costantino M. F., Cozza F., Cucchini U., D'Angelo M., Ros S. D., D'Andrea F., D'Andrea A., D'Auria F., De Caridi G., De Feo S., De Matteis G. M., De Vecchi S., Del Giudice C., Dell'Angela L., Delli Paoli L., Dentamaro I., Destefanis P., Di Fulvio M., Di Gaetano R., Di Giannuario G., Di Gioia A., Di Martino L. F. M., Di Muro C., Di Nora C., Di Salvo G., Dodi C., Dogliani S., Donati F., Dottori M., Epifani G., Fabiani I., Ferrara F., Ferrara L., Ferrua S., Filice G., Fiorino M., Forno D., Garini A., Giarratana G. A., Gigantino G., Giorgi M., Giubertoni E., Greco C. A., Grigolato M., Marra W. G., Holzl A., Iaiza A., Iannaccone A., Ilardi F., Imbalzano E., Inciardi R., Inserra C. A., Iori E., Izzo A., La Rosa G., Labanti G., Lanzone A. M., Lanzoni L., Lapetina O., Leiballi E., Librera M., Lo Conte C., Lo Monaco M., Lombardo A., Luciani M., Lusardi P., Magnante A., Malagoli A., Malatesta G., Mancusi C., Manes M. T., Manganelli F., Mantovani F., Manuppelli V., Marchese V., Marinacci L., Mattioli R., Maurizio C., Mazza G. A., Mazza S., Melis M., Meloni G., Merli E., Milan A., Minardi G., Monaco A., Monte I., Montresor G., Moreo A., Mori F., Morini S., Moro C., Morrone D., Negri F., Nipote C., Nisi F., Nocco S., Novello L., Nunziata L., Perini A. P., Parodi A., Pasanisi E. M., Pastorini G., Pavasini R., Pavoni D., Pedone C., Pelliccia F., Pelliciari G., Pelloni E., Pergola V., Perillo G., Petruccelli E., Pezzullo C., Piacentini G., Picardi E., Pinna G., Pizzarelli M., Pizzuti A., Poggi M. M., Posteraro A., Privitera C., Rampazzo D., Ratti C., Rettegno S., Ricci F., Ricci C., Rolando C., Rossi S., Rovera C., Ruggieri R., Russo M. G., Sacchi N., Saladino A., Sani F., Sartori C., Scarabeo V., Sciacqua A., Scillone A., Scopelliti P. A., Scorza A., Scozzafava A., Serafini F., Serra W., Severino S., Simeone B., Sirico D., Solari M., Spadaro G. L., Stefani L., Strangio A., Surace F. C., Tamborini G., Tarquinio N., Tassone E. J., Tavarozzi I., Tchana B., Tedesco G., Tinto M., Torzillo D., Totaro A., Triolo O. F., Troisi F., Tusa M., Vancheri F., Varasano V., Venezia A., Vermi A. C., Villari B., Zampi G., Zannoni J., Zito C., Zugaro A., Di Bella G., and Carerj S.
Abstract: Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers (P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue
Published: 2023

2. The ischemic cascades in contemporary patients: five distinct phenotypes assessed by ABCDE stress echocardiography

Author: Zagatina, A, primary, Ciampi, Q, additional, Cortigiani, L, additional, Wierzbowska-Drabik, K, additional, Haberka, M, additional, Djordjevic-Dikic, A, additional, Boshchenko, A, additional, Rigo, F, additional, Simova, I, additional, Dodi, C, additional, Gaibazzi, N, additional, Morrone, D, additional, Barbieri, A, additional, Pellikka, PA, additional, and Picano, E, additional
Published: 2022
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3. Quality control of B-lines analysis in stress Echo 2020

Author: Scali, M. C., Ciampi, Q., Picano, E., Bossone, E., Ferrara, F., Citro, R., Colonna, P., Costantino, M. F., Cortigiani, L., Andrea, A. D., Severino, S., Dodi, C., Gaibazzi, N., Galderisi, M., Barbieri, A., Monte, I., Mori, F., Reisenhofer, B., Re, F., Rigo, F., Trambaiolo, P., Amor, M., Lowenstein, J., Merlo, P. M., Daros, C. B., De Castro E Silva Pretto, J. L., Miglioranza, M. H., Torres, M. A. R., De Azevedo Bellagamba, C. C., Chaves, D. Q., Simova, I., Varga, A., Celutkiene, J., Kasprzak, J. D., Wierzbowska-Drabik, K., Lipiec, P., Weiner-Mik, P., Szymczyk, E., Wdowiak-Okrojek, K., Djordjevic-Dikic, A., Dekleva, M., Stankovic, I., Neskovic, A. N., Zagatina, A., Di Salvo, G., Perez, J. E., Camarozano, A. C., Corciu, A. I., Boshchenko, A., Lattanzi, F., Cotrim, C., Fazendas, P., Haberka, M., Sobkowic, B., Kosmala, W., Witkowski, T., Gosciniak, P., Salustri, A., Rodriguez-Zanella, H., Leal, L. I. M., Nikolic, A., Gligorova, S., Urluescu, M. -L., Fiorino, M., Novo, G., Preradovic-Kovacevic, T., Ostojic, M., Beleslin, B., Villari, B., De Nes, M., Paterni, M., Carpeggiani, C., Andreassi, M. G., Scali, Maria Chiara, Ciampi, Quirino, Picano, Eugenio, Bossone, Eduardo, Ferrara, Francesco, Citro, Rodolfo, Colonna, Paolo, Costantino, Marco Fabio, Cortigiani, Lauro, Andrea, Antonello D'., Severino, Sergio, Dodi, Claudio, Gaibazzi, Nicola, Galderisi, Maurizio, Barbieri, Andrea, Monte, Ine, Mori, Fabio, Reisenhofer, Barbara, Re, Federica, Rigo, Fausto, Trambaiolo, Paolo, Amor, Miguel, Lowenstein, Jorge, Merlo, Pablo Martin, Daros, Clarissa Borguezan, De Castro E Silva Pretto, José Lui, Miglioranza, Marcelo Haertel, Torres, Marco A. R., De Azevedo Bellagamba, Clarissa Carmona, Chaves, Daniel Quesada, Simova, Iana, Varga, Albert, Čelutkiene, Jelena, Kasprzak, Jaroslaw D., Wierzbowska-Drabik, Karina, Lipiec, Piotr, Weiner-Mik, Paulina, Szymczyk, Eva, Wdowiak-Okrojek, Katarzyna, Djordjevic-Dikic, Ana, Dekleva, Milica, Stankovic, Ivan, Neskovic, Aleksandar N., Zagatina, Angela, Di Salvo, Giovanni, Perez, Julio E., Camarozano, Ana Cristina, Corciu, Anca Irina, Boshchenko, Alla, Lattanzi, Fabio, Cotrim, Carlo, Fazendas, Paula, Haberka, Maciej, Sobkowic, Bozena, Kosmala, Wojciech, Witkowski, Tomasz, Gosciniak, Piotr, Salustri, Alessandro, Rodriguez-Zanella, Hugo, Leal, Luis Ignacio Martin, Nikolic, Alexandra, Gligorova, Suzana, Urluescu, Madalina-Loredana, Fiorino, Maria, Novo, Giuseppina, Preradovic-Kovacevic, Tamara, Ostojic, Miodrag, Beleslin, Branko, Villari, Bruno, De Nes, Michele, Paterni, Marco, Carpeggiani, Clara, Andreassi, Maria Grazia, Scali, Mc, Ciampi, Q, Picano, E, Bossone, E, Ferrara, F, Citro, R, Colonna, P, Costantino, Mf, Cortigiani, L, D'Andrea, A, Severino, S, Dodi, C, Gaibazzi, N, Galderisi, M, Barbieri, A, Monte, I, Mori, F, Reisenhofer, B, Re, F, Rigo, F, Trambaiolo, P, Amor, M, Lowenstein, J, Merlo, Pm, Daros, Cb, Pretto, Jlde, Miglioranza, Mh, Torres, Mar, Bellagamba, Ccd, Chaves, Dq, Simova, I, Varga, A, Celutkiene, J, Kasprzak, Jd, Wierzbowska-Drabik, K, Lipiec, P, Weiner-Mik, P, Szymczyk, E, Wdowiak-Okrojek, K, Djordjevic-Dikic, A, Dekleva, M, Stankovic, I, Neskovic, An, Zagatina, A, Di Salvo, G, Perez, Je, Camarozano, Ac, Corciu, Ai, Boshchenko, A, Lattanzi, F, Cotrim, C, Fazendas, P, Haberka, M, Sobkowic, B, Kosmala, W, Witkowski, T, Gosciniak, P, Salustri, A, Rodriguez-Zanella, H, Leal, Lim, Nikolic, A, Gligorova, S, Urluescu, Ml, Fiorino, M, Novo, G, Preradovic-Kovacevic, T, Ostojic, M, Beleslin, B, Villari, B, De Nes, M, Paterni, M, and Carpeggiani, C
Subjects: Male, lcsh:Diseases of the circulatory (Cardiovascular) system, Diagnostic accuracy, 030204 cardiovascular system & hematology, 0302 clinical medicine, Nuclear Medicine and Imaging, Reading (process), Medicine, Lung, media_common, Controle de qualidade, certification, lung comets, quality control, stress echocardiography, wall motion, General Medicine, Middle Aged, Echocardiography, Female, Radiology, Cardiology and Cardiovascular Medicine, Human, Echocardiography, Stress, Quality Control, Certification, Lung comets, Quality control, Stress echocardiography, Wall motion, Humans, Internet, Pulmonary Edema, Radiology, Nuclear Medicine and Imaging, medicine.medical_specialty, Correlation coefficient, media_common.quotation_subject, Stress, Lung comet, Ecocardiografia sob estresse, 03 medical and health sciences, Echocardiography, Stre, Internal medicine, Radiology, Nuclear Medicine and imaging, Quality (business), Doenças cardiovasculares, business.industry, 030208 emergency & critical care medicine, Gold standard (test), Lung ultrasound, lcsh:RC666-701, Stress Echo, Nuclear medicine, business, Certificação
Abstract: Background The effectiveness trial “Stress echo (SE) 2020” evaluates novel applications of SE in and beyond coronary artery disease. The core protocol also includes 4-site simplified scan of B-lines by lung ultrasound, useful to assess pulmonary congestion. Purpose To provide web-based upstream quality control and harmonization of B-lines reading criteria. Methods 60 readers (all previously accredited for regional wall motion, 53 B-lines naive) from 52 centers of 16 countries of SE 2020 network read a set of 20 lung ultrasound video-clips selected by the Pisa lab serving as reference standard, after taking an obligatory web-based learning 2-h module ( http://se2020.altervista.org ). Each test clip was scored for B-lines from 0 (black lung, A-lines, no B-lines) to 10 (white lung, coalescing B-lines). The diagnostic gold standard was the concordant assessment of two experienced readers of the Pisa lab. The answer of the reader was considered correct if concordant with reference standard reading ±1 (for instance, reference standard reading of 5 B-lines; correct answer 4, 5, or 6). The a priori determined pass threshold was 18/20 (≥ 90%) with R value (intra-class correlation coefficient) between reference standard and recruiting center) > 0.90. Inter-observer agreement was assessed with intra-class correlation coefficient statistics. Results All 60 readers were successfully accredited: 26 (43%) on first, 24 (40%) on second, and 10 (17%) on third attempt. The average diagnostic accuracy of the 60 accredited readers was 95%, with R value of 0.95 compared to reference standard reading. The 53 B-lines naive scored similarly to the 7 B-lines expert on first attempt (90 versus 95%, p = NS). Compared to the step-1 of quality control for regional wall motion abnormalities, the mean reading time per attempt was shorter (17 ± 3 vs 29 ± 12 min, p
Published: 2018

4. Molecular epidemiology of KPC-producing Klebsiella pneumoniae from invasive infections in Italy: Increasing diversity with predominance of the ST512 clade II sublineage

Author: Conte, Viola, Monaco, Monica, Giani, Tommaso, D'Ancona, Fortunato, Moro, Maria Luisa, Arena, Fabio, D'Andrea, Marco Maria, Rossolini, Gian Maria, Pantosti, Annalisa, Bianchi, E., Catania, M. R., Cavalcanti, P., De Nittis, R., Dusi, P. A., Grandesso, S., Gualdi, P., Imbriani, A., Pini, B., Vincenzi, C., Meledandri, M., Agrappi, C., Parisi, G., Pollini, S., Restelli, A., Rocchetti, A., Vailati, F., Aschbacher, R., Barbaro, A., Bona, R., Chirillo, M., Corradini, S., Cuccurullo, S., De Bernochi, A., Dodi, C., Giammanco, A., Mencacci, Antonella, Milano, F., Miragliotta, G., Mungiguerra, M., Pedna, M. F., Piana, Francesca, Porcheddu, G. M., Rossi, M. R., Santino, I., Sartor, A., Sartore, P., Conte V., Monaco M., Giani T., D'Ancona F., Moro M.L., Arena F., D'Andrea M.M., Rossolini G.M., Pantosti A., Bianchi E., Catania M.R., Cavalcanti P., De Nittis R., Dusi P.A., Grandesso S., Gualdi P., Imbriani A., Pini B., Vincenzi C., Meledandri M., Agrappi C., Parisi G., Pollini S., Restelli A., Rocchetti A., Vailati F., Aschbacher R., Barbaro A., Bona R., Chirillo M., Corradini S., Cuccurullo S., De Bernochi A., Dodi C., Giammanco A., Mencacci A., Milano F., Miragliotta G., Mungiguerra M., Pedna M.F., Piana F., Porcheddu G.M., Rossi M.R., Santino I., Sartor A., Sartore P., Conte, V, Monaco, M, Giani, T, D'Ancona, F, Moro, Ml, Arena, F, D'Andrea, Mm, Rossolini, Gm, Pantosti, A, AR-ISS Study Group on Carbapenemase-Producing K., pneumoniae: Bianchi E, Catania, Mr, Cavalcanti, P, De Nittis, R, Dusi, Pa, Grandesso, S, Gualdi, P, Imbriani, A, Pini, B, Vincenzi, C, Meledandri, Alessio, Agrappi, C, Parisi, G, Pollini, S, Restelli, Ugo, Rocchetti, Romualdo, Vailati, F, Aschbacher, R, Barbaro, A, Bona, R, Chirillo, M, Corradini, S, Cuccurullo, S, De Bernochi, A, Dodi, C, Giammanco, Anna, Mencacci, A, Milano, F, Miragliotta, Giuseppe, Mungiguerra, M, Pedna, Mf, Piana, Daniela, Porcheddu, Gm, Rossi, Mr, Santino, I, Sartor, A, and Sartore, P.
Subjects: 0301 basic medicine, Microbiology (medical), gel, Klebsiella pneumoniae, genotype, 030106 microbiology, Population, cross-sectional studies, pulsed-field, multilocus sequence typing, electrophoresis, gel, pulsed-field, humans, italy, klebsiella infections, klebsiella pneumoniae, molecular epidemiology, serogroup, beta-lactamases, genetic variation, Settore BIO/19 - Microbiologia Generale, Cross-Sectional Studies, Electrophoresis, Gel, Pulsed-Field, Humans, Italy, Klebsiella Infections, Molecular Epidemiology, Multilocus Sequence Typing, Serogroup, beta-Lactamases, Genetic Variation, Genotype, Pharmacology, Pharmacology (medical), Infectious Diseases, law.invention, Microbiology, beta-Lactamase, 03 medical and health sciences, law, Pulsed-field gel electrophoresis, Typing, education, Polymerase chain reaction, Cross-Sectional Studie, education.field_of_study, biology, Molecular epidemiology, biochemical phenomena, metabolism, and nutrition, biology.organism_classification, Settore MED/07 - Microbiologia e Microbiologia Clinica, bacterial infections and mycoses, Virology, electrophoresis, Multilocus sequence typing, Human, Klebsiella Infection
Abstract: Objectives The spread of carbapenem-resistant Enterobacteriaceae (CRE) represents one of the most worrisome problems for clinical medicine worldwide. In Italy, the Antibiotic-Resistance-Istituto Superiore di Sanita surveillance network, in collaboration with the Committee for Antimicrobial Agents of the Italian Society of Clinical Microbiologists, promoted a study to investigate the carbapenem-resistance mechanisms, clonal relatedness and capsular typing of a recent collection of carbapenem-resistant Klebsiella pneumoniae (CR-KP). Methods A total of 17 laboratories distributed across Italy collected all consecutive non-replicate CR-KP isolated from invasive infections during two different study periods (2011-12 and 2013). Carbapenemase genes were searched for by filter hybridization and confirmed by PCR and sequencing. KPC-producing K. pneumoniae (KPC-KP) were typed by PFGE and MLST. Capsular types were identified by wzi gene typing. Results Of the collected K. pneumoniae isolates (n = 461), the overall proportion of CR-KP was 36.2% (n = 167). The majority (97%) of the CR-KP were positive for the blaKPC gene. Among the KPC-KP population, nine different STs were detected with the majority of isolates (94%) belonging to the clonal group (CG) 258. A subpopulation that belonged to ST512 and showed an identical PFGE profile represented the majority (57%) of KPC-KP strains, with a countrywide distribution. Capsular characterization showed the predominance of the wzi154, cps-2 capsular type (88.8% of all CG258 strains). ST258 strains were associated with both cps-1 and cps-2 capsular types, while ST512 was associated with cps-2 only. Conclusions Although a trend to a polyclonal evolution of the Italian KPC-KP was noted, this study showed that the KPC-KP population remained largely oligoclonal with the wide diffusion of an ST512 lineage carrying cps-2 capsular type and producing the KPC-3 enzyme.
Published: 2016

5. Enhanced resolution of random amplified polymorphic DNA genotyping of Pseudomonas aeruginosa

Author: Barnini, S., Dodi, C., and Campa, M.
Published: 2004

6. [The interplay of diagnostic and antimicrobial stewardship for the management of septic patients: the Tuscan model.]

Author: Forni, S., Toccafondi, G., Viaggi, B., Grazzini, M., D'Arienzo, S., Gemmi, F., Vannucci, A., Tulli, G., Rossolini, G. M., Pecile, P., Cusi, M. G., Cresti, S., Barnini, S., Mattei, R., Salamone, D., Petricci, P., Vettori, C., Bianchi, L., degli Innocenti, R., Dodi, C., Rebuffat, A., Batignani, T., Galanti, I., Valentini, S., D'Andrea, M. M., and Covello, B.
Subjects: Antimicrobial Stewardship, Microbial, Anti-Infective Agents, Italy, Drug Resistance, Microbial, Humans, Laboratories, Sepsis, Drug Resistance, Settore MED/07 - Microbiologia e Microbiologia Clinica, Settore BIO/19 - Microbiologia Generale
Abstract: Antimicrobial resistance is a global threat caused by the rapid spread of multiresistant microorganisms. Antimicrobial stewardship (AS) is a coordinated intervention designed to improve the appropriate use of antimicrobials by promoting the selection of the optimal drug regimen, dose, duration of therapy and route of administration. AS programs have proved effective in reducing antimicrobial resistance, inappropriate antimicrobial use and in improving patient outcomes. Recently developed rapid diagnostic technologies in microbiology (RDTM) allows a faster and etiological diagnosis of infection and a reduction in the use of unnecessary empirical therapies. This may result in important advancement in time-critical care pathways for septic patients. Nevertheless, RDTM are costly and if not rationally positioned may consume resources and hinder the efficacy of AS programs. In this regard, Tuscany Region is engaged in designing, through a systemic approach, an effective high-quality clinical microbiological service grid. In order to develop a sustainable and equitable model for integrating diagnostic and antimicrobial stewardship we conducted a survey in the regional network of 14 microbiological laboratories. The results shows that in order to develop a sustainable service we need to improve the communication at the interface between laboratories and care unit, harmonize the time windows for processing samples and to devise a robust score for stratifying patient with suspected sepsis.
Published: 2018

7. Indagini microbiologiche su campioni di adenoidectomia e tonsillectomia

Author: Castagna, B., Dodi, C., Barnini, S., Corsini, V., Malizia, T., Giannotti, A., Lico, S., CECCHERINI-NELLI, Luca, Casani, AUGUSTO PIETRO, Marchetti, M. SELLARI FRANCESCHINI S., and Campa, M.
Subjects: Indagini microbiologiche, adenoidectomia, tonsillectomia
Published: 2004

8. Indagini microbiologiche su campioni da adenoidectomia e tonsillectomia

Author: Castagna, Maura, Dodi, C, Barnini, S, Corsini, V, Malizia, T, Giannotti, A, Lico, S, CECCHERINI-NELLI, Luca, Casani, AUGUSTO PIETRO, Marchetti, M, SELLARI FRANCESCHINI, Stefano, and Campa, Mario
Published: 2003

9. Madness and method in stress echo reading

Author: Varga, A., primary, Picano, E., additional, Dodi, C., additional, Barbieri, A., additional, Pratali, L., additional, and Gaddi, O., additional
Published: 1999
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10. Stress echocardiography for risk stratification in woman with chest pain

Author: Cortigiani, L., primary, Dodi, C., additional, Paolini, E., additional, Bruno, G., additional, and Nannini, E., additional
Published: 1998
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11. Effects of antianginal therapy with a calcium antagonist and nitrates on dobutamine--atropine stress echocardiography: Comparison with exercise electrocardiography

Author: Dodi, C., primary, Pingitore, A., additional, Sicari, R., additional, Bruno, G., additional, Cordovil, A., additional, and Picano, E., additional
Published: 1997
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12. The incremental prognostic value of pharmacological stress echo over exercise electrocardiography in women with chest pain of unknown origin.

Author: Dodi, C, Cortigiani, L, Masini, M, Olivotto, I, Azzarelli, A, and Nannini, E
Abstract: Aims The value of exercise electrocardiography in evaluating women with suspected coronary artery disease is limited. Conversely, stress echocardiography is effective for both diagnostic and prognostic purposes in females. The purpose of the study was to determine the relative prognostic value of exercise electrocardiography and pharmacological stress echocardiography in a cohort of women with chest pain of unknown origin, in order to verify whether criteria could be established for the daily non-invasive evaluation of such a low-risk profile population.Methods and Results Exercise electrocardiography and pharmacological stress echocardiography (171 dipyridamole, 73 dobutamine) were performed in 244 women (age 60±10 years) with chest pain and known coronary artery disease. A positive result of exercise electrocardiography (ST-segment shift ≥1mm at 80ms after the J point) was detected in 95 patients; a positive result of stress echocardiography (new regional wall motion abnormalities) was observed in 33 patients. During follow-up (36±18 months), two deaths, five infarctions, seven unstable anginas, and 11 coronary revascularizations occurred. Using Cox analysis, the positive result of stress echocardiography (odds ratio=40·1) alone, was independently related to hard cardiac events (death, infarction). With spontaneous cardiac events (death, infarction, and unstable angina) as end-points, the multivariate prognostic predictors were a positive result of stress echocardiography (odds ratio= 37·0), a family history of coronary artery disease (odds ratio=4·1), typical chest pain (odds ratio=3·7), and a positive exercise electrocardiography result with a rate–pressure product ≤20000 (odds ratio=3·5). By adopting an interactive stepwise procedure, the prognostic value of stress echocardiography was incremental to that of clinical and exercise electrocardiography data. Nevertheless, the negative result of exercise electrocardiography and pharmacological stress predicted a very high and comparable (P=ns) 24-month survival rate when both hard and spontaneous cardiac events were taken as end-points.Conclusions In women with chest pain, stress echocardiography is a strong and independent prognostic indicator, incremental to that shown by exercise electrocardiography. However, the two tests have a similar high negative predictive value in this population. Therefore, exercise electrocardiography has to be considered the initial approach and the only test when the result is negative, whereas stress echocardiography is warranted in selected conditions, including those in women with uninterpretable electrocardiograms, those unable to exercise maximally, and those with an ambiguous or ischaemic response to exercise electrocardiography. [ABSTRACT FROM PUBLISHER]
Published: 2001
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13. Dipyridamole Echocardiography for Diagnosis of Coexistent Coronary Artery Disease in Hypertrophic Cardiomyopathy

Author: Lazzeroni, E., Picano, E., Dodi, C., and Morozzi, L.
Published: 1995
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14. Functional, Anatomical, and Prognostic Correlates of Coronary Flow Velocity Reserve During Stress Echocardiography

Author: Fausto Rigo, Iana Simova, Antonello D'Andrea, Pablo Merlo, Clarissa Borguezan Daros, Eugenio Picano, Alla A. Boshchenko, Eduardo Bossone, Suzana Gligorova, Fabio Marco Costantino, Nadezhda Zhuravskaya, Ana Djordjevic-Dikic, Albert Varga, Michele De Nes, Rodolfo Citro, Marco Antonio Rodrigues Torres, Marco Paterni, Dario Gregori, Milica Dekleva, Maria Chiara Scali, Angela Zagatina, Sergio Severino, Alessandro Salustri, Clara Carpeggiani, Lauro Cortigiani, Alexander V. Vrublevsky, Fabio Lattanzi, Paolo Colonna, Ines Monte, Quirino Ciampi, Hugo Rodríguez-Zanella, Jorge Lowenstein, Jarosław D. Kasprzak, Nicola Gaibazzi, Claudio Dodi, José Luis de Castro e Silva Pretto, Karina Wierzbowska-Drabik, Miguel Amor, Ciampi, Q., Zagatina, A., Cortigiani, L., Gaibazzi, N., Borguezan Daros, C., Zhuravskaya, N., Wierzbowska-Drabik, K., Kasprzak, J. D., de Castro e Silva Pretto, J. L., D'Andrea, A., Djordjevic-Dikic, A., Monte, I., Simova, I., Boshchenko, A., Citro, R., Amor, M., Merlo, P. M., Dodi, C., Rigo, F., Gligorova, S., Dekleva, M., Severino, S., Lattanzi, F., Scali, M. C., Vrublevsky, A., Torres, M. A. R., Salustri, A., Rodriguez-Zanella, H., Costantino, F. M., Varga, A., Bossone, E., Colonna, P., De Nes, M., Paterni, M., Carpeggiani, C., Lowenstein, J., Gregori, D., and Picano, E.
Subjects: Male, coronary artery disease, coronary flow velocity reserve, heart failure, lung ultrasound, stress echocardiography, medicine.medical_specialty, Diastole, 030204 cardiovascular system & hematology, Anterior Descending Coronary Artery, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Stress Echocardiography, Humans, Prospective Studies, 030212 general & internal medicine, Aged, Ejection fraction, business.industry, Odds ratio, Middle Aged, Prognosis, medicine.disease, 3. Good health, Fractional Flow Reserve, Myocardial, Heart failure, Cardiology, Female, Dobutamine, Cardiology and Cardiovascular Medicine, business, Blood Flow Velocity, Echocardiography, Stress, medicine.drug
Abstract: Background: The assessment of coronary flow velocity reserve (CFVR) in left anterior descending coronary artery (LAD) expands the risk stratification potential of stress echocardiography (SE) based on stress-induced regional wall motion abnormalities (RWMA). Objectives: The purpose of this study was to assess the feasibility and functional correlates of CFVR. Methods: This prospective, observational, multicenter study initially screened 3,410 patients (2,061 [60%] male; age 63 ± 11 years; ejection fraction 61 ± 9%) with known or suspected coronary artery disease and/or heart failure. All patients underwent SE (exercise, n = 1,288; vasodilator, n = 1,860; dobutamine, n = 262) based on new or worsening RWMA in 20 accredited laboratories of 8 countries. CFVR was calculated as the stress/rest ratio of diastolic peak flow velocity pulsed-Doppler assessment of LAD flow. A subset of 1,867 patients was followed up. Results: The success rate for CFVR on LAD was 3,002 of 3,410 (feasibility = 88%). Reduced (≤2.0) CFVR was found in 896 of 3,002 (30%) patients. At multivariable logistic regression analysis, inducible RWMA (odds ratio [OR]: 6.5; 95% confidence interval [CI]: 4.9 to 8.5; p < 0.01), abnormal left ventricular contractile reserve (OR: 3.4; 95% CI: 2.7 to 4.2; p < 0.01), and B-lines (OR: 1.5; 95% CI: 1.1 to 1.9; p = 0.01) were associated with reduced CFVR. During a median follow-up time of 16 months, 218 events occurred. RWMA (hazard ratio: 3.8; 95% CI: 2.3 to 6.3; p < 0.001) and reduced CFVR (hazard ratio: 1.5; 95% CI: 1.1 to 2.2; p = 0.009) were independently associated with adverse outcome. Conclusions: CFVR is feasible with all SE protocols. Reduced CFVR is often accompanied by RWMA, abnormal LVCR, and pulmonary congestion during stress, and shows independent value over RWMA in predicting an adverse outcome.
Published: 2019

15. Lung Ultrasound and Pulmonary Congestion During Stress Echocardiography

Author: Fausto Rigo, Katarzyna Wdowiak-Okrojek, Fabio Lattanzi, Ana Djordjevic-Dikic, Karina Wierzbowska-Drabik, Eugenio Picano, Francesco Ferrara, Paul E Vargas Mieles, Doralisa Morrone, Angela Zagatina, Claudio Dodi, Barbara Reisenhofer, Tamara Preradovic-Kovacevic, Jarosław D. Kasprzak, Hugo Rodríguez-Zanella, Miguel Amor, Aleksandra Nikolic, Alessandro Salustri, Clarissa Borguezan Daros, Nicola Gaibazzi, Maciej Haberka, Federica Re, Iana Simova, Nikola Boskovic, Gergely Ágoston, Eduardo Bossone, Marco Paterni, Antonello D'Andrea, Clara Carpeggiani, Michele De Nes, Quirino Ciampi, Ewa Szymczyk, Sergio Severino, Maria Chiara Scali, Fabio Mori, Diego M. Lowenstein Haber, Miodrag Ostojic, Lauro Cortigiani, Milica Dekleva, Ana Cristina Camarozano, Giovanni Di Salvo, Maria Grazia D'Alfonso, Maurizio Galderisi, Alla A. Boshchenko, José Luis de Castro e Silva Pretto, Milorad Tesic, Branko Beleslin, Elisa Merli, Alexander V. Vrublevsky, Paulina Wejner-Mik, T. Bombardini, Paolo Colonna, Jelena Celutkiene, Fabio Marco Costantino, Ines Monte, Valentina Lorenzoni, Jorge Lowenstein, Pablo Merlo, Martina Vladova, Suzana Gligorova, Andrea Barbieri, Nadezhda Zhuravskaya, Albert Varga, R Arbucci, Rodolfo Citro, Marco Antonio Rodrigues Torres, Marcelo Haertel Miglioranza, Marija Petrović, Scali, M. C., Zagatina, A., Ciampi, Q., Cortigiani, L., D'Andrea, A., Daros, C. B., Zhuravskaya, N., Kasprzak, J. D., Wierzbowska-Drabik, K., Luis de Castro e Silva Pretto, J., Djordjevic-Dikic, A., Beleslin, B., Petrovic, M., Boskovic, N., Tesic, M., Monte, I., Simova, I., Vladova, M., Boshchenko, A., Vrublevsky, A., Citro, R., Amor, M., Vargas Mieles, P. E., Arbucci, R., Merlo, P. M., Lowenstein Haber, D. M., Dodi, C., Rigo, F., Gligorova, S., Dekleva, M., Severino, S., Lattanzi, F., Morrone, D., Galderisi, M., Torres, M. A. R., Salustri, A., Rodriguez-Zanella, H., Costantino, F. M., Varga, A., Agoston, G., Bossone, E., Ferrara, F., Gaibazzi, N., Celutkiene, J., Haberka, M., Mori, F., D'Alfonso, M. G., Reisenhofer, B., Camarozano, A. C., Miglioranza, M. H., Szymczyk, E., Wejner-Mik, P., Wdowiak-Okrojek, K., Preradovic-Kovacevic, T., Bombardini, T., Ostojic, M., Nikolic, A., Re, F., Barbieri, A., Di Salvo, G., Merli, E., Colonna, P., Lorenzoni, V., De Nes, M., Paterni, M., Carpeggiani, C., Lowenstein, J., and Picano, E.
Subjects: medicine.medical_specialty, stress echocardiography, heart failure, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Predictive Value of Tests, Internal medicine, Dobutamine, Heart rate, medicine, Stress Echocardiography, Humans, Radiology, Nuclear Medicine and imaging, Myocardial infarction, Lung, lung ultrasound, business.industry, Hazard ratio, medicine.disease, Prognosis, coronary artery disease, Coronary Vessels, 3. Good health, Heart failure, Cardiology, Cardiology and Cardiovascular Medicine, business, medicine.drug, Echocardiography, Stress
Abstract: Objectives The purpose of this study was to assess the functional and prognostic correlates of B-lines during stress echocardiography (SE). Background B-profile detected by lung ultrasound (LUS) is a sign of pulmonary congestion during SE. Methods The authors prospectively performed transthoracic echocardiography (TTE) and LUS in 2,145 patients referred for exercise (n = 1,012), vasodilator (n = 1,054), or dobutamine (n = 79) SE in 11 certified centers. B-lines were evaluated in a 4-site simplified scan (each site scored from 0: A-lines to 10: white lung for coalescing B-lines). During stress the following were also analyzed: stress-induced new regional wall motion abnormalities in 2 contiguous segments; reduced left ventricular contractile reserve (peak/rest based on force, ≤2.0 for exercise and dobutamine, ≤1.1 for vasodilators); and abnormal coronary flow velocity reserve ≤2.0, assessed by pulsed-wave Doppler sampling in left anterior descending coronary artery and abnormal heart rate reserve (peak/rest heart rate) ≤1.80 for exercise and dobutamine (≤1.22 for vasodilators). All patients completed follow-up. Results According to B-lines at peak stress patients were divided into 4 different groups: group I, absence of stress B-lines (score: 0 to 1; n = 1,389; 64.7%); group II, mild B-lines (score: 2 to 4; n = 428; 20%); group III, moderate B-lines (score: 5 to 9; n = 209; 9.7%) and group IV, severe B-lines (score: ≥10; n = 119; 5.4%). During median follow-up of 15.2 months (interquartile range: 12 to 20 months) there were 38 deaths and 28 nonfatal myocardial infarctions in 64 patients. At multivariable analysis, severe stress B-lines (hazard ratio [HR]: 3.544; 95% confidence interval [CI]: 1.466 to 8.687; p = 0.006), abnormal heart rate reserve (HR: 2.276; 95% CI: 1.215 to 4.262; p = 0.010), abnormal coronary flow velocity reserve (HR: 2.178; 95% CI: 1.059 to 4.479; p = 0.034), and age (HR: 1.031; 95% CI: 1.002 to 1.062; p = 0.037) were independent predictors of death and nonfatal myocardial infarction. Conclusions Severe stress B-lines predict death and nonfatal myocardial infarction. (Stress Echo 2020 - The International Stress Echo Study [SE2020]; NCT03049995)
Published: 2020

16. Prognostic significance of the dobutamine echocardiography test in idiopathic dilated cardiomyopathy.

Author: Pratali, Lorenza, Picano, Eugenio, Otasevic, Peter, Vigna, Carlo, Palinkas, Attila, Cortigiani, Lauro, Dodi, Claudio, Bojic, Dragana, Varga, Albert, Csanady, Miklos, Landi, Patrizia, Pratali, L, Picano, E, Otasevic, P, Vigna, C, Palinkas, A, Cortigiani, L, Dodi, C, Bojic, D, and Varga, A
Subjects: *STRESS echocardiography, *DOBUTAMINE, *CARDIOMYOPATHIES
Abstract: Dobutamine stress echo provides potentially useful information on idiopathic dilated cardiomyopathy (IDC). From February 1, 1997, to October 1, 1999, 186 patients (131 men and 55 women, mean age 56 +/- 12 years) with IDC, ejection fraction <35%, and angiographically normal coronary arteries were studied by high-dose (up to 40 micro/kg/min) dobutamine echo in 6 centers, all quality controlled for stress echo reading. In all patients, wall motion score index (WMSI) (from 1 = normal to 4 = dyskinetic in a 16- segment model of the left ventricle) was evaluated by echo at baseline and peak dobutamine. One hundred eighty-four patients were followed up (mean 15 +/- 13 months) and only cardiac death was considered as an end point. There were 29 cardiac deaths. Significant parameters for survival prediction at univariate analysis are: DeltaWMSI (chi-square 20.1; p <0.0000), New York Heart Association (NYHA) class (chi-square 17.57; p <0.0000), rest ejection fraction (chi-square 10.41; p = 0.0013), angiotensin-converting enzyme inhibitors (chi-square 8.23; p = 0.0041), and hypertension (chi-square 8.08, p = 0.0045). In the multivariate stepwise analysis only DeltaWMSI and NYHA were independent predictors of outcome (DeltaWMSI = hazard ratio 0.02, p < 0.0000; NYHA class = hazard ratio 3.83, p < 0.0000). Kaplan-Meier survival estimates showed a better outcome for patients with a large inotropic response (DeltaWMSI > or =0.44, a cutoff identified by receiver-operating characteristic curves analysis) than for those with a small or no myocardial inotropic response to dobutamine (93.6% vs 69.4%, p = 0.00033). Thus, in patients with IDC, an extensive contractile reserve identified by high-dose dobutamine stress echocardiography is associated with a better survival. [ABSTRACT FROM AUTHOR]
Published: 2001
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17. Stress Echocardiography in Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author: Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Da Ros S, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Del Giudice C, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Bella G, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi RM, Inserra CA, Iori E, Izzo A, La Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Picano E, and Carerj S
Abstract: Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and ≥40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity ( P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001)., Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)
Published: 2023
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18. Organization and Activity of Italian Echocardiographic Laboratories: A Survey of the Italian Society of Echocardiography and Cardiovascular Imaging.

Author: Ciampi Q, Pepi M, Antonini-Canterin F, Barbieri A, Barchitta A, Faganello G, Miceli S, Parato VM, Tota A, Trocino G, Abbate M, Accadia M, Alemanni R, Angelini A, Anglano F, Anselmi M, Aquila I, Aramu S, Avogadri E, Azzaro G, Badano L, Balducci A, Ballocca F, Barbarossa A, Barbati G, Barletta V, Barone D, Becherini F, Benfari G, Beraldi M, Bergandi G, Bilardo G, Binno SM, Bolognesi M, Bongiovi S, Bragato RM, Braggion G, Brancaleoni R, Bursi F, Dessalvi CC, Cameli M, Canu A, Capitelli M, Capra ACM, Carbonara R, Carbone M, Carbonella M, Carrabba N, Casavecchia G, Casula M, Chesi E, Cicco S, Citro R, Cocchia R, Colombo BM, Colonna P, Conte M, Corrado G, Cortesi P, Cortigiani L, Costantino MF, Cozza F, Cucchini U, D'Angelo M, Ros SD, D'Andrea F, D'Andrea A, D'Auria F, De Caridi G, De Feo S, De Matteis GM, De Vecchi S, Giudice CD, Dell'Angela L, Paoli LD, Dentamaro I, Destefanis P, Di Fulvio M, Di Gaetano R, Di Giannuario G, Di Gioia A, Di Martino LFM, Di Muro C, Di Nora C, Di Salvo G, Dodi C, Dogliani S, Donati F, Dottori M, Epifani G, Fabiani I, Ferrara F, Ferrara L, Ferrua S, Filice G, Fiorino M, Forno D, Garini A, Giarratana GA, Gigantino G, Giorgi M, Giubertoni E, Greco CA, Grigolato M, Marra WG, Holzl A, Iaiza A, Iannaccone A, Ilardi F, Imbalzano E, Inciardi R, Inserra CA, Iori E, Izzo A, Rosa G, Labanti G, Lanzone AM, Lanzoni L, Lapetina O, Leiballi E, Librera M, Conte CL, Monaco ML, Lombardo A, Luciani M, Lusardi P, Magnante A, Malagoli A, Malatesta G, Mancusi C, Manes MT, Manganelli F, Mantovani F, Manuppelli V, Marchese V, Marinacci L, Mattioli R, Maurizio C, Mazza GA, Mazza S, Melis M, Meloni G, Merli E, Milan A, Minardi G, Monaco A, Monte I, Montresor G, Moreo A, Mori F, Morini S, Moro C, Morrone D, Negri F, Nipote C, Nisi F, Nocco S, Novello L, Nunziata L, Perini AP, Parodi A, Pasanisi EM, Pastorini G, Pavasini R, Pavoni D, Pedone C, Pelliccia F, Pelliciari G, Pelloni E, Pergola V, Perillo G, Petruccelli E, Pezzullo C, Piacentini G, Picardi E, Pinna G, Pizzarelli M, Pizzuti A, Poggi MM, Posteraro A, Privitera C, Rampazzo D, Ratti C, Rettegno S, Ricci F, Ricci C, Rolando C, Rossi S, Rovera C, Ruggieri R, Russo MG, Sacchi N, Saladino A, Sani F, Sartori C, Scarabeo V, Sciacqua A, Scillone A, Scopelliti PA, Scorza A, Scozzafava A, Serafini F, Serra W, Severino S, Simeone B, Sirico D, Solari M, Spadaro GL, Stefani L, Strangio A, Surace FC, Tamborini G, Tarquinio N, Tassone EJ, Tavarozzi I, Tchana B, Tedesco G, Tinto M, Torzillo D, Totaro A, Triolo OF, Troisi F, Tusa M, Vancheri F, Varasano V, Venezia A, Vermi AC, Villari B, Zampi G, Zannoni J, Zito C, Zugaro A, Di Bella G, and Carerj S
Abstract: Background: The Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand better how different echocardiographic modalities are used and accessed in Italy., Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved via an electronic survey based on a structured questionnaire, uploaded on the SIECVI website., Results: Data were obtained from 228 echocardiographic laboratories: 112 centers (49%) in the northern, 43 centers (19%) in the central, and 73 (32%) in the southern regions. During the month of observation, we collected 101,050 transthoracic echocardiography (TTE) examinations performed in all centers. As concern other modalities there were performed 5497 transesophageal echocardiography (TEE) examinations in 161/228 centers (71%); 4057 stress echocardiography (SE) examinations in 179/228 centers (79%); and examinations with ultrasound contrast agents (UCAs) in 151/228 centers (66%). We did not find significant regional variations between the different modalities. The usage of picture archiving and communication system (PACS) was significantly higher in the northern (84%) versus central (49%) and southern (45%) centers ( P < 0.001). Lung ultrasound (LUS) was performed in 154 centers (66%), without difference between cardiology and noncardiology centers. The evaluation of left ventricular (LV) ejection fraction was evaluated mainly using the qualitative method in 223 centers (94%), occasionally with the Simpson method in 193 centers (85%), and with selective use of the three-dimensional (3D) method in only 23 centers (10%). 3D TTE was present in 137 centers (70%), and 3D TEE in all centers where TEE was done (71%). The assessment of LV diastolic function was done routinely in 80% of the centers. Right ventricular function was evaluated using tricuspid annular plane systolic excursion in all centers, using tricuspid valve annular systolic velocity by tissue Doppler imaging in 53% of the centers, and using fractional area change in 33% of the centers. When we divided into cardiology (179, 78%) and noncardiology (49, 22%) centers, we found significant differences in the SE (93% vs. 26%, P < 0.001), TEE (85% vs. 18%), UCA (67% vs. 43%, P < 0001), and STE (87% vs. 20%, P < 0.001). The incidence of LUS evaluation was similar between the cardiology and noncardiology centers (69% vs. 61%, P = NS)., Conclusions: This nationwide survey demonstrated that digital infrastructures and advanced echocardiography modalities, such as 3D and STE, are widely available in Italy with a notable diffuse uptake of LUS in the core TTE examination, a suboptimal diffusion of PACS recording, and conservative use of UCA, 3D, and strain. There are significant differences between northern and central-southern regions and echocardiographic laboratories that pertain to the cardiac unit. This inhomogeneous distribution of technology represents one of the main issues that must be solved to standardize the practice of echocardiography., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Cardiovascular Echography.)
Published: 2023
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19. Pulmonary Congestion During Exercise Stress Echocardiography in Ischemic and Heart Failure Patients.

Author: Merli E, Ciampi Q, Scali MC, Zagatina A, Merlo PM, Arbucci R, Daros CB, de Castro E Silva Pretto JL, Amor M, Salamè MF, Mosto H, Morrone D, D'Andrea A, Reisenhofer B, Rodriguez-Zanella H, Wierzbowska-Drabik K, Kasprzak JD, Agoston G, Varga A, Lowenstein J, Dodi C, Cortigiani L, Simova I, Samardjieva M, Citro R, Celutkiene J, Re F, Monte I, Gligorova S, Antonini-Canterin F, Pepi M, Carpeggiani C, Pellikka PA, and Picano E
Subjects: Humans, Lung diagnostic imaging, Prognosis, Stroke Volume physiology, Echocardiography, Stress, Heart Failure
Abstract: Background: Lung ultrasound detects pulmonary congestion as B-lines at rest, and more frequently, during exercise stress echocardiography (ESE)., Methods: We performed ESE plus lung ultrasound (4-site simplified scan) in 4392 subjects referred for semi-supine bike ESE in 24 certified centers in 9 countries. B-line score ranged from 0 (normal) to 40 (severely abnormal). Five different populations were evaluated: control subjects (n=103); chronic coronary syndromes (n=3701); heart failure with reduced ejection fraction (n=395); heart failure with preserved ejection fraction (n=70); ischemic mitral regurgitation ≥ moderate at rest (n=123). In a subset of 2478 patients, follow-up information was available., Results: During ESE, B-lines increased in all study groups except controls. Age, hypertension, abnormal ejection fraction, peak wall motion score index, and abnormal heart rate reserve were associated with B-lines in multivariable regression analysis. Stress B lines (hazard ratio, 2.179 [95% CI, 1.015-4.680]; P =0.046) and ejection fraction <50% (hazard ratio, 2.942 [95% CI, 1.268-6.822]; P =0.012) were independent predictors of all-cause death (n=29 after a median follow-up of 29 months)., Conclusions: B-lines identify the pulmonary congestion phenotype at rest, and more frequently, during ESE in ischemic and heart failure patients. Stress B-lines may help to refine risk stratification in these patients., Registration: URL: https://www., Clinicaltrials: gov; Unique identifier: NCT03049995.
Published: 2022
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20. Feasibility and value of two-dimensional volumetric stress echocardiography.

Author: Bombardini T, Zagatina A, Ciampi Q, Cortigiani L, D'Andrea A, Borguezan Daros C, Zhuravskaya N, Kasprzak JD, Wierzbowska-Drabik K, de Castro E Silva Pretto JL, Djordjevic-Dikic A, Beleslin B, Petrovic M, Boskovic N, Tesic M, Monte IP, Simova I, Vladova M, Boshchenko A, Ryabova T, Citro R, Amor M, Vargas Mieles PE, Arbucci R, Dodi C, Rigo F, Gligorova S, Dekleva M, Severino S, Torres MA, Salustri A, Rodrìguez-Zanella H, Costantino FM, Varga A, Agoston G, Bossone E, Ferrara F, Gaibazzi N, Rabia G, Celutkiene J, Haberka M, Mori F, D'Alfonso MG, Reisenhofer B, Camarozano AC, Salamé M, Szymczyk E, Wejner-Mik P, Wdowiak-Okrojek K, Kovacevic Preradovic T, Lattanzi F, Morrone D, Scali MC, Ostojic M, Nikolic A, Re F, Barbieri A, DI Salvo G, Colonna P, DE Nes M, Paterni M, Merlo PM, Lowenstein J, Carpeggiani C, Gregori D, and Picano E
Subjects: Aged, Dobutamine, Echocardiography methods, Feasibility Studies, Humans, Male, Middle Aged, Echocardiography, Stress methods, Heart Failure
Abstract: Background: Stroke volume response during stress is a major determinant of functional status in heart failure and can be measured by two-dimensional (2-D) volumetric stress echocardiography (SE). The present study hypothesis is that SE may identify mechanisms underlying the change in stroke volume by measuring preload reserve through end-diastolic volume (EDV) and left ventricular contractile reserve (LVCR) with systolic blood pressure and end-systolic volume (ESV)., Methods: We enrolled 4735 patients (age 63.6±11.3 years, 2800 male) referred to SE for known or suspected coronary artery disease (CAD) and/or heart failure (HF) in 21 SE laboratories in 8 countries. In addition to regional wall motion abnormalities (RWMA), force was measured at rest and peak stress as the ratio of systolic blood pressure by cuff sphygmomanometer/ESV by 2D with Simpson's or linear method. Abnormal values of LVCR (peak/rest) based on force were ≤1.10 for dipyridamole (N.=1992 patients) and adenosine (N.=18); ≤2.0 for exercise (N.=2087) or dobutamine (N.=638)., Results: Force-based LVCR was obtained in all 4735 patients. Lack of stroke volume increase during stress was due to either abnormal LVCR and/or blunted preload reserve, and 57% of patients with abnormal LVCR nevertheless showed increase in stroke volume., Conclusions: Volumetric SE is highly feasible with all stresses, and more frequently impaired in presence of ischemic RWMA, absence of viability and reduced coronary flow velocity reserve. It identifies an altered stroke volume response due to reduced preload and/or contractile reserve.
Published: 2022
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21. Prognostic value of stress echocardiography assessed by the ABCDE protocol.

Author: Ciampi Q, Zagatina A, Cortigiani L, Wierzbowska-Drabik K, Kasprzak JD, Haberka M, Djordjevic-Dikic A, Beleslin B, Boshchenko A, Ryabova T, Gaibazzi N, Rigo F, Dodi C, Simova I, Samardjieva M, Barbieri A, Morrone D, Lorenzoni V, Prota C, Villari B, Antonini-Canterin F, Pepi M, Carpeggiani C, Pellikka PA, and Picano E
Subjects: Aged, Coronary Vessels diagnostic imaging, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Dobutamine, Echocardiography, Stress
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 X2 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., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Published: 2021
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22. Coronary Flow, Left Ventricular Contractile and Heart Rate Reserve in Non-Ischemic Heart Failure.

Author: Daros CB, Ciampi Q, Cortigiani L, Gaibazzi N, Rigo F, Wierzbowska-Drabik K, Kasprzak JD, Dodi C, Villari B, Antonini-Canterin F, Lorenzoni V, Nes M, Carpeggiani C, Picano E, and On Behalf Of The Stress Echo Study Group Of The Italian Society Of Echocardiography And Cardiovascular Imaging
Abstract: Background : Left ventricular contractile reserve (LVCR), coronary flow velocity reserve (CFVR), and heart rate reserve (HRR) affect outcome in heart failure (HF). They can be simultaneously measured during dipyridamole stress echocardiography (DSE). Aim : To assess the value of comprehensive DSE in patients with non-ischemic HF. Methods : We evaluated 610 patients with HF, no history of coronary artery disease, and no inducible regional wall motion abnormalities: 270 patients with preserved ejection fraction (≥50%), 146 patients with mid-range ejection fraction (40-49%), and 194 patients with reduced ejection fraction (<40%). All underwent DSE (0.84 mg/kg in 6') in 7 accredited laboratories. We measured LVCR (abnormal value ≤ 1.1), CFVR in left anterior descending artery (abnormal value: ≤2.0), and HRR (peak/rest heart rate; abnormal value: ≤1.22). All patients were followed up. Results : Abnormal CFVR, LVCR, and HRR occurred in 29%, 45%, and 47% of patients, respectively ( p < 0.001). After a median follow-up time of 20 months (interquartile range: 12-32 months), 113 hard events occurred in 105 patients with 41 deaths, 8 myocardial infarctions, 61 admissions for acute HF, and 3 strokes. The annual mortality rates were 0.8% in 200 patients with none abnormal criteria, 1.8% in 184 patients with 1 abnormal criterion, 7.1% in 130 patients with 2 abnormal criteria, 7.5% in 96 patients with 3 abnormal criteria. Conclusions : Abnormal LVCR, CFVR, and HRR were frequent during DSE in non-ischemic HF patients. They target different pathophysiological vulnerabilities (myocardial function, coronary microcirculation, and cardiac autonomic balance) and are useful for outcome prediction.
Published: 2021
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23. Coronavirus disease 2019 infection in patients with recent cardiac surgery: does chronic anticoagulant therapy have a protective effect?

Author: Inama G, Dodi C, Provini M, Bossoni E, Inama L, Balzarini L, Mancini C, Ramponi S, and Marvisi M
Subjects: Aged, Anti-Infective Agents administration & dosage, COVID-19, Combined Modality Therapy methods, Female, Humans, Male, Outcome and Process Assessment, Health Care, Tomography, X-Ray Computed methods, Anticoagulants therapeutic use, Azithromycin administration & dosage, Cardiac Surgical Procedures adverse effects, Cardiac Surgical Procedures methods, Coronavirus Infections blood, Coronavirus Infections diagnosis, Coronavirus Infections mortality, Coronavirus Infections physiopathology, Hydroxychloroquine administration & dosage, Pandemics, Platelet Aggregation Inhibitors therapeutic use, Pneumonia, Viral blood, Pneumonia, Viral diagnosis, Pneumonia, Viral etiology, Pneumonia, Viral mortality, Pneumonia, Viral physiopathology, Postoperative Complications blood, Postoperative Complications prevention & control, Postoperative Complications virology
Abstract: Aims: The aim of this study was to evaluate the clinical course of COVID-19 in patients who had recently undergone a cardiac procedure and were inpatients in a cardiac rehabilitation department., Methods: All patients hospitalized from 1 February to 15 March 2020 were included in the study (n = 35; 16 men; mean age 78 years). The overall population was divided into two groups: group 1 included 10 patients who presented with a clinical picture of COVID-19 infection and were isolated, and group 2 included 25 patients who were COVID-19-negative. In group 1, nine patients were on chronic oral anticoagulant therapy and one patient was on acetylsalicylic acid (ASA) and clopidogrel. A chest computed tomography scan revealed interstitial pneumonia in all 10 patients., Results: During hospitalization, COVID-19 patients received azithromycin and hydroxychloroquine in addition to their ongoing therapy. Only the patient on ASA with clopidogrel therapy was transferred to the ICU for mechanical ventilation because of worsening respiratory failure, and subsequently died from cardiorespiratory arrest. All other patients on chronic anticoagulant therapy recovered and were discharged., Conclusion: Our study suggests that COVID-19 patients on chronic anticoagulant therapy may have a more favorable and less complicated clinical course. Further prospective studies are warranted to confirm this preliminary observation.
Published: 2020
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24. Lung Ultrasound and Pulmonary Congestion During Stress Echocardiography.

Author: Scali MC, Zagatina A, Ciampi Q, Cortigiani L, D'Andrea A, Daros CB, Zhuravskaya N, Kasprzak JD, Wierzbowska-Drabik K, Luis de Castro E Silva Pretto J, Djordjevic-Dikic A, Beleslin B, Petrovic M, Boskovic N, Tesic M, Monte I, Simova I, Vladova M, Boshchenko A, Vrublevsky A, Citro R, Amor M, Vargas Mieles PE, Arbucci R, Merlo PM, Lowenstein Haber DM, Dodi C, Rigo F, Gligorova S, Dekleva M, Severino S, Lattanzi F, Morrone D, Galderisi M, Torres MAR, Salustri A, Rodrìguez-Zanella H, Costantino FM, Varga A, Agoston G, Bossone E, Ferrara F, Gaibazzi N, Celutkiene J, Haberka M, Mori F, D'Alfonso MG, Reisenhofer B, Camarozano AC, Miglioranza MH, Szymczyk E, Wejner-Mik P, Wdowiak-Okrojek K, Preradovic-Kovacevic T, Bombardini T, Ostojic M, Nikolic A, Re F, Barbieri A, Di Salvo G, Merli E, Colonna P, Lorenzoni V, De Nes M, Paterni M, Carpeggiani C, Lowenstein J, and Picano E
Subjects: Coronary Vessels diagnostic imaging, Dobutamine, Humans, Lung, Predictive Value of Tests, Prognosis, Echocardiography, Stress
Abstract: Objectives: The purpose of this study was to assess the functional and prognostic correlates of B-lines during stress echocardiography (SE)., Background: B-profile detected by lung ultrasound (LUS) is a sign of pulmonary congestion during SE., Methods: The authors prospectively performed transthoracic echocardiography (TTE) and LUS in 2,145 patients referred for exercise (n = 1,012), vasodilator (n = 1,054), or dobutamine (n = 79) SE in 11 certified centers. B-lines were evaluated in a 4-site simplified scan (each site scored from 0: A-lines to 10: white lung for coalescing B-lines). During stress the following were also analyzed: stress-induced new regional wall motion abnormalities in 2 contiguous segments; reduced left ventricular contractile reserve (peak/rest based on force, ≤2.0 for exercise and dobutamine, ≤1.1 for vasodilators); and abnormal coronary flow velocity reserve ≤2.0, assessed by pulsed-wave Doppler sampling in left anterior descending coronary artery and abnormal heart rate reserve (peak/rest heart rate) ≤1.80 for exercise and dobutamine (≤1.22 for vasodilators). All patients completed follow-up., Results: According to B-lines at peak stress patients were divided into 4 different groups: group I, absence of stress B-lines (score: 0 to 1; n = 1,389; 64.7%); group II, mild B-lines (score: 2 to 4; n = 428; 20%); group III, moderate B-lines (score: 5 to 9; n = 209; 9.7%) and group IV, severe B-lines (score: ≥10; n = 119; 5.4%). During median follow-up of 15.2 months (interquartile range: 12 to 20 months) there were 38 deaths and 28 nonfatal myocardial infarctions in 64 patients. At multivariable analysis, severe stress B-lines (hazard ratio [HR]: 3.544; 95% confidence interval [CI]: 1.466 to 8.687; p = 0.006), abnormal heart rate reserve (HR: 2.276; 95% CI: 1.215 to 4.262; p = 0.010), abnormal coronary flow velocity reserve (HR: 2.178; 95% CI: 1.059 to 4.479; p = 0.034), and age (HR: 1.031; 95% CI: 1.002 to 1.062; p = 0.037) were independent predictors of death and nonfatal myocardial infarction., Conclusions: Severe stress B-lines predict death and nonfatal myocardial infarction. (Stress Echo 2020-The International Stress Echo Study [SE2020]; NCT03049995)., (Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2020
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25. Functional, Anatomical, and Prognostic Correlates of Coronary Flow Velocity Reserve During Stress Echocardiography.

Author: Ciampi Q, Zagatina A, Cortigiani L, Gaibazzi N, Borguezan Daros C, Zhuravskaya N, Wierzbowska-Drabik K, Kasprzak JD, de Castro E Silva Pretto JL, D'Andrea A, Djordjevic-Dikic A, Monte I, Simova I, Boshchenko A, Citro R, Amor M, Merlo PM, Dodi C, Rigo F, Gligorova S, Dekleva M, Severino S, Lattanzi F, Scali MC, Vrublevsky A, Torres MAR, Salustri A, Rodrìguez-Zanella H, Costantino FM, Varga A, Bossone E, Colonna P, De Nes M, Paterni M, Carpeggiani C, Lowenstein J, Gregori D, and Picano E
Subjects: Aged, Blood Flow Velocity, Coronary Artery Disease mortality, Female, Heart Failure mortality, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease physiopathology, Echocardiography, Stress, Fractional Flow Reserve, Myocardial physiology, Heart Failure diagnostic imaging, Heart Failure physiopathology
Abstract: Background: The assessment of coronary flow velocity reserve (CFVR) in left anterior descending coronary artery (LAD) expands the risk stratification potential of stress echocardiography (SE) based on stress-induced regional wall motion abnormalities (RWMA)., Objectives: The purpose of this study was to assess the feasibility and functional correlates of CFVR., Methods: This prospective, observational, multicenter study initially screened 3,410 patients (2,061 [60%] male; age 63 ± 11 years; ejection fraction 61 ± 9%) with known or suspected coronary artery disease and/or heart failure. All patients underwent SE (exercise, n = 1,288; vasodilator, n = 1,860; dobutamine, n = 262) based on new or worsening RWMA in 20 accredited laboratories of 8 countries. CFVR was calculated as the stress/rest ratio of diastolic peak flow velocity pulsed-Doppler assessment of LAD flow. A subset of 1,867 patients was followed up., Results: The success rate for CFVR on LAD was 3,002 of 3,410 (feasibility = 88%). Reduced (≤2.0) CFVR was found in 896 of 3,002 (30%) patients. At multivariable logistic regression analysis, inducible RWMA (odds ratio [OR]: 6.5; 95% confidence interval [CI]: 4.9 to 8.5; p < 0.01), abnormal left ventricular contractile reserve (OR: 3.4; 95% CI: 2.7 to 4.2; p < 0.01), and B-lines (OR: 1.5; 95% CI: 1.1 to 1.9; p = 0.01) were associated with reduced CFVR. During a median follow-up time of 16 months, 218 events occurred. RWMA (hazard ratio: 3.8; 95% CI: 2.3 to 6.3; p < 0.001) and reduced CFVR (hazard ratio: 1.5; 95% CI: 1.1 to 2.2; p = 0.009) were independently associated with adverse outcome., Conclusions: CFVR is feasible with all SE protocols. Reduced CFVR is often accompanied by RWMA, abnormal LVCR, and pulmonary congestion during stress, and shows independent value over RWMA in predicting an adverse outcome., (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Published: 2019
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26. The Functional Meaning of B-Profile During Stress Lung Ultrasound.

Author: Scali MC, Zagatina A, Ciampi Q, Cortigiani L, D'Andrea A, Djordjevic-Dikic A, Merlo PM, Lattanzi F, Simova I, Monte I, Dodi C, Kasprzak JD, Galderisi M, Boshchenko A, Rigo F, Varga A, Dekleva M, Re F, de Castro E Silva Pretto JL, Zhuravaskaya N, Wierzbowska-Drabik K, Coviello K, Citro R, Colonna P, Carpeggiani C, and Picano E
Subjects: Aged, Female, Humans, Lung physiopathology, Male, Middle Aged, Myocardial Ischemia complications, Myocardial Ischemia physiopathology, Predictive Value of Tests, Prospective Studies, Pulmonary Edema etiology, Pulmonary Edema physiopathology, Echocardiography, Stress, Exercise Test, Lung diagnostic imaging, Myocardial Ischemia diagnostic imaging, Pulmonary Edema diagnostic imaging, Vasodilator Agents administration & dosage
Published: 2019
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27. Quality control of regional wall motion analysis in stress Echo 2020.

Author: Ciampi Q, Picano E, Paterni M, Daros CB, Simova I, de Castro E Silva Pretto JL, Scali MC, Gaibazzi N, Severino S, Djordjevic-Dikic A, Kasprzak JD, Zagatina A, Varga A, Lowenstein J, Merlo PM, Amor M, Celutkiene J, Perez JE, Di Salvo G, Galderisi M, Mori F, Costantino MF, Massa L, Dekleva M, Chaves DQ, Trambaiolo P, Citro R, Colonna P, Rigo F, Torres MAR, Monte I, Stankovic I, Neskovic A, Cortigiani L, Re F, Dodi C, D'Andrea A, Villari B, Arystan A, De Nes M, and Carpeggiani C
Subjects: Coronary Disease epidemiology, Echocardiography, Stress methods, Humans, Internationality, Reproducibility of Results, Cardiologists standards, Clinical Competence standards, Coronary Disease diagnostic imaging, Echocardiography, Stress standards, Quality Control
Abstract: Background: The trial "Stress Echo (SE) 2020" evaluates novel applications of SE beyond coronary artery disease. The aim of the study was control quality and harmonize reading criteria., Methods: One reader from 78 centers of the SE 2020 network asked for credentials to read a set of 20 SE video-clips selected by the core lab. All aspiring centers met the pre-requisite of high-volume and the years of experience in SE ranged from 5 to 31years (mean value 18years). The diagnostic gold standard was a reading by the core lab. The a priori determined pass threshold was 18/20 (≥90%)., Results: Of the initial 78 who started, 57 completed the first attempt: individual readers' score on first attempt ranged from 07/20 to 20/20 (accuracy from 35% to 100%, mean 78.7±13%) and 44 readers passed it. There was a very poor correlation between years of experience and the reader's score on first attempt (r=-0.161, p=0.231). Of the 13 readers who failed the first attempt, 12 took it again after the web-based session and their accuracy improved (74% vs. 96%, p<0.001). The kappa inter-observer agreement before and after web-based training was 0.59 on first attempt and rose to 0.91 on the last attempt., Conclusions: In SE reading, the volume of activity or years of experience is not synonymous with diagnostic quality. Qualitative analysis and operator-dependence can become a limiting weakness in clinical practice, in the absence of strict pathways of learning, credentialing and audit., (Copyright © 2017 Elsevier B.V. All rights reserved.)
Published: 2017
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28. Stress echocardiography with smartphone: real-time remote reading for regional wall motion.

Author: Scali MC, de Azevedo Bellagamba CC, Ciampi Q, Simova I, de Castro E Silva Pretto JL, Djordjevic-Dikic A, Dodi C, Cortigiani L, Zagatina A, Trambaiolo P, Torres MR, Citro R, Colonna P, Paterni M, and Picano E
Subjects: Brazil, Coronary Angiography, Europe, Feasibility Studies, Humans, Myocardial Ischemia physiopathology, Observer Variation, Predictive Value of Tests, Prognosis, Prospective Studies, Reproducibility of Results, Echocardiography, Stress instrumentation, Mobile Applications, Myocardial Ischemia diagnostic imaging, Remote Consultation instrumentation, Smartphone
Abstract: The diffusion of smart-phones offers access to the best remote expertise in stress echo (SE). To evaluate the reliability of SE based on smart-phone filming and reading. A set of 20 SE video-clips were read in random sequence with a multiple choice six-answer test by ten readers from five different countries (Italy, Brazil, Serbia, Bulgaria, Russia) of the "SE2020" study network. The gold standard to assess accuracy was a core-lab expert reader in agreement with angiographic verification (0 = wrong, 1 = right). The same set of 20 SE studies were read, in random order and >2 months apart, on desktop Workstation and via smartphones by ten remote readers. Image quality was graded from 1 = poor but readable, to 3 = excellent. Kappa (k) statistics was used to assess intra- and inter-observer agreement. The image quality was comparable in desktop workstation vs. smartphone (2.0 ± 0.5 vs. 2.4 ± 0.7, p = NS). The average reading time per case was similar for desktop versus smartphone (90 ± 39 vs. 82 ± 54 s, p = NS). The overall diagnostic accuracy of the ten readers was similar for desktop workstation vs. smartphone (84 vs. 91%, p = NS). Intra-observer agreement (desktop vs. smartphone) was good (k = 0.81 ± 0.14). Inter-observer agreement was good and similar via desktop or smartphone (k = 0.69 vs. k = 0.72, p = NS). The diagnostic accuracy and consistency of SE reading among certified readers was high and similar via desktop workstation or via smartphone.
Published: 2017
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29. New rapid methods cannot replace the current method to diagnose bloodstream infections.

Author: Lupetti A, Barnini S, Dodi C, Menconi M, Favre C, Giagnoni M, Florio W, Nibbering PH, and Campa M
Subjects: Bacteria drug effects, Fungi drug effects, Humans, Bacteria isolation & purification, Blood microbiology, Fungi isolation & purification, Microbiological Techniques methods, Molecular Diagnostic Techniques methods, Sepsis diagnosis
Published: 2014
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30. Prediction of mortality in patients with right bundle branch block referred for pharmacologic stress echocardiography.

Author: Cortigiani L, Bigi R, Gigli G, Dodi C, Mariotti E, Coletta C, Astarita C, and Picano E
Subjects: Age Factors, Aged, Cardiotonic Agents, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Dipyridamole, Dobutamine, Female, Humans, Male, Myocardial Contraction, Myocardial Ischemia complications, Myocardial Ischemia diagnostic imaging, Predictive Value of Tests, Survival Analysis, Vasodilator Agents, Bundle-Branch Block mortality, Echocardiography, Stress, Risk Assessment
Abstract: Right bundle branch block (RBBB) is independently associated with all-cause mortality in patients referred for noninvasive evaluation of coronary artery disease. However, further stratification of risk in these patients has not been specifically addressed. The aim of this study was to risk stratify patients with RBBB who were referred for stress echocardiography. The study population was comprised of 343 patients (267 men; age 66 +/- 9 years) with RBBB who underwent pharmacologic stress echocardiography (231 dipyridamole, 112 dobutamine) for evaluation of suspected or known coronary artery disease. Overall mortality was the only end point. Stress echocardiography was positive for ischemia in 109 patients (32%). During follow-up (38 +/- 32 months), 36 deaths occurred. Seventy-three patients underwent revascularization and were censored. Ischemia at stress echocardiography (hazard ratio [HR] 2.9, 95% confidence interval [CI] 1.5 to 5.5, p=0.002), left anterior fascicular block (LAFB) (HR 2.8, 95% CI 1.4 to 5.6, p = 0.002), age >65 years (HR 2.1, 95% CI 1.0 to 4.3, p=0.047), and wall motion score index at rest (HR 2.5, 95% CI 1.0 to 6.5, p=0.057) were multivariate predictors of mortality. On the basis of stress echocardiographic result and presence and/or absence of LAFB, 3 levels of risk were identified: (1) low-risk, in cases of no ischemia and no LAFB (49% of the entire study population); (2) intermediate-risk, in cases of ischemia or LAFB only; and (3) high-risk, in cases of ischemia and LAFB. Clinical data, electrocardiography at rest, and stress echocardiographic results can provide effective stratification of risk in patients with RBBB.
Published: 2003
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31. Prognostic implications of intraventricular conduction defects in patients undergoing stress echocardiography for suspected coronary artery disease.

Author: Cortigiani L, Bigi R, Gigli G, Coletta C, Mariotti E, Dodi C, Astarita C, and Picano E
Subjects: Aged, Coronary Artery Disease surgery, Electrocardiography instrumentation, Female, Follow-Up Studies, Humans, Hypertension complications, Hypertension diagnosis, Male, Middle Aged, Myocardial Revascularization methods, Prospective Studies, Bundle-Branch Block complications, Bundle-Branch Block diagnosis, Coronary Artery Disease complications, Coronary Artery Disease diagnosis, Echocardiography, Stress methods
Abstract: Purpose: To investigate the prognostic implications of conduction defects in subjects without proven coronary artery disease who had been referred for stress echocardiography., Methods: The study sample consisted of 1230 patients (574 men and 656 women; mean [+/- SD] age, 63 +/- 10 years) who underwent stress echocardiography with dipyridamole (n = 780) or dobutamine (n = 450) to evaluate suspected coronary artery disease. A summary wall motion score (on a 1 to 4 scale) was calculated. Patients were followed for a mean of 41 +/- 27 months; mortality was the only endpoint., Results: Four hundred and twenty patients (34%) had intraventricular conduction defects on a resting electrocardiogram (173 with complete left bundle branch block, 98 with isolated right bundle branch block, 43 with right bundle branch block with left anterior hemiblock, and 106 with left anterior hemiblock). Ischemia at stress echo (new or worsening of preexisting wall motion abnormality) was found in 250 patients (20%). There were 56 deaths during follow-up; 138 patients underwent revascularization and were censored. Multivariate predictors of mortality were resting wall motion score index (hazard ratio [HR] = 6.0 per unit increase; 95% confidence interval [CI]: 2.3 to 16; P <0.0001), ischemia at stress echo (HR = 3.9; 95% CI: 2.2 to 6.7; P <0.0001), age >65 years (HR = 3.2; 95% CI: 1.7 to 5.9; P <0.0001), hypertension (HR = 1.8; 95% CI: 1.1 to 3.2; P = 0.03), and right bundle branch block with left anterior hemiblock (HR = 3.7; 95% CI: 1.8 to 7.5; P <0.0001). The other three forms of intraventricular conduction defects (left bundle branch block, isolated complete right bundle branch block, and left anterior hemiblock) were not associated with mortality in multivariate analyses, or among the 980 patients who did not have ischemia., Conclusion: Right bundle branch block with left anterior hemiblock is an independent predictor of mortality in patients with suspected coronary artery disease undergoing stress echocardiography, whereas isolated right bundle branch block is associated with outcomes similar to those observed in patients with no conduction defects.
Published: 2003
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32. Prognostic value of pharmacological stress echocardiography in women with chest pain and unknown coronary artery disease.

Author: Cortigiani L, Dodi C, Paolini EA, Bernardi D, Bruno G, and Nannini E
Subjects: Aged, Cardiotonic Agents pharmacology, Dipyridamole, Dobutamine pharmacology, Echocardiography methods, Feasibility Studies, Female, Humans, Image Processing, Computer-Assisted, Middle Aged, Predictive Value of Tests, Prognosis, Risk Assessment, Vasodilator Agents, Chest Pain diagnostic imaging, Coronary Disease diagnostic imaging
Abstract: Objectives: In this study we sought to investigate the prognostic value of pharmacological stress echocardiography in women referred for chest pain, having unknown coronary artery disease., Background: The noninvasive identification of a high-risk subgroup among women with chest pain and unknown coronary artery disease is an unresolved task to date., Methods: A total of 456 women (mean [+/-SD] age 63+/-10 years) underwent pharmacological stress echocardiography with either dipyridamole (n = 305) or dobutamine (n = 151) for evaluation of chest pain and were followed-up for 32+/-19 months. None of them had a previous diagnosis of coronary artery disease., Results: No major complication occurred during stress testing. Five tests (1.1%) were prematurely interrupted because of the appearance of side effects. Echocardiographic positivity was identified in 51 patients. During the follow-up, 23 cardiac events occurred: 3 deaths, 10 infarctions and 10 cases of unstable angina; an additional 21 patients underwent coronary revascularization. At Cox analysis, the echocardiographic evidence of ischemia was found as the only independent predictor of hard cardiac events (death, infarction) (odds ratio [OR] = 27.5; 95% confidence interval [CI] = (6.5 to 115.5; p = 0.0000). When spontaneous cardiac events (death, infarction and unstable angina) were considered as endpoints, the positive echocardiographic result (OR = 23.9; 95% CI = 8.6 to 66.8; p = 0.0000) and family history of coronary artery disease (OR = 3.7; 95% CI = 1.5 to 9.1; p = 0.0037) were independently correlated with prognosis. By using an interactive stepwise procedure, the prognostic value of stress echocardiography was found to be incremental to that provided by clinical variables, both considering hard and spontaneous cardiac events as endpoints. The 3-year survival rate for the negative and the positive population was respectively, 99.5% and 69.5% (p = 0.0000) considering hard cardiac events, 99.2% and 50.6% (p = 0.0000) considering spontaneous cardiac events., Conclusions: Pharmacological stress echocardiography is safe, highly feasible and effective in risk stratification of women with chest pain and unknown coronary artery disease, also when hard endpoints are considered. Its use can have relevant implications in daily clinical practice for selection of patients needing further investigations.
Published: 1998
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33. Prognostic value of myocardial viability in medically treated patients with global left ventricular dysfunction early after an acute uncomplicated myocardial infarction: a dobutamine stress echocardiographic study.

Author: Picano E, Sicari R, Landi P, Cortigiani L, Bigi R, Coletta C, Galati A, Heyman J, Mattioli R, Previtali M, Mathias W Jr, Dodi C, Minardi G, Lowenstein J, Seveso G, Pingitore A, Salustri A, and Raciti M
Subjects: Aged, Angina, Unstable diagnostic imaging, Angina, Unstable mortality, Atropine, Dobutamine, Exercise Test methods, Female, Follow-Up Studies, Humans, Male, Middle Aged, Myocardial Infarction mortality, Parasympatholytics, Predictive Value of Tests, Prognosis, Survival Analysis, Sympathomimetics, Ventricular Dysfunction, Left mortality, Echocardiography, Myocardial Infarction diagnostic imaging, Ventricular Dysfunction, Left diagnostic imaging
Abstract: Background: Residual viable myocardium identified by dobutamine stress after myocardial infarction may act as an unstable substrate for further events such as subsequent angina and reinfarction. However, in patients with severe global left ventricular dysfunction, viability might be protective rather than detrimental. The aim of this study was to assess the impact on survival of echocardiographically detected viability in medically treated patients with global left ventricular dysfunction evaluated after acute uncomplicated myocardial infarction., Methods and Results: The data bank of the large-scale, prospective, multicenter, observational Echo Dobutamine International Cooperative (EDIC) study was interrogated to select 314 medically treated patients (271 men; age, 58+/-9 years) who underwent low-dose (1.6). Patients were followed up for 9+/-7 months. Low-dose dobutamine stress echocardiography identified myocardial viability in 130 patients (52%). Dobutamine-atropine stress echocardiography was positive for ischemia in 148 patients (47%) and negative in 166 patients (53%). During the follow-up, there were 12 cardiac deaths (3.8% of the total population). With the use of Cox proportional hazards model, delta low-dose WMSI (the variation between rest WMSI and low-dose WMSI) was shown to exert a protective effect by reducing cardiac death by 0.8 for each decrease in WMSI at low-dose dobutamine (coefficient, -0.2; hazard ratio, 0.8; P<0.03); WMSI at peak stress was the best predictor of cardiac death in this set of patients (hazard ratio, 14.9; P<0.0018)., Conclusions: In medically treated patients with severe global left ventricular dysfunction early after acute uncomplicated myocardial infarction, the presence of myocardial viability identified as inotropic reserve after low-dose dobutamine is associated with a higher probability of survival. The higher the number of segments showing improvement of function, the better the impact is of myocardial viability on survival. The presence of inducible ischemia in this set of patients is the best predictor of cardiac death.
Published: 1998
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34. Prognostic value of dobutamine-atropine stress echocardiography early after acute myocardial infarction. Echo Dobutamine International Cooperative (EDIC) Study.

Author: Sicari R, Picano E, Landi P, Pingitore A, Bigi R, Coletta C, Heyman J, Casazza F, Previtali M, Mathias W Jr, Dodi C, Minardi G, Lowenstein J, Garyfallidis X, Cortigiani L, Morales MA, and Raciti M
Subjects: Adult, Aged, Aged, 80 and over, Angina, Unstable diagnostic imaging, Angina, Unstable therapy, Angioplasty, Balloon, Coronary, Atropine, Cell Survival, Coronary Artery Bypass, Female, Humans, Male, Middle Aged, Myocardial Infarction pathology, Myocardial Infarction therapy, Predictive Value of Tests, Prognosis, Prospective Studies, Cardiotonic Agents, Dobutamine, Echocardiography, Myocardial Infarction diagnostic imaging
Abstract: Objectives: The aim of this multicenter, multinational, prospective, observational study was to assess the relative value of myocardial viability and induced ischemia early after uncomplicated myocardial infarction., Background: Dobutamine-atropine stress echocardiography allows evaluation of rest function (at baseline), myocardial viability (at low dose) and residual ischemia (peak dose, up to 40 micrograms with atropine up to 1 mg) in one test., Methods: Dobutamine-atropine stress echocardiography was performed 12 +/- 5 days (mean +/- SD) after a first uncomplicated acute myocardial infarction in 778 patients (677 men; mean age 58 +/- 10 years) with technically satisfactory rest echocardiographic study results. Patients were followed-up for 9 +/- 7 months., Results: Dobutamine-atropine stress echocardiographic findings were positive for myocardial ischemia in 436 of patients (56%) and negative in 342 (44%). During follow-up, there were 14 cardiac-related deaths (1.8% of the total cohort), 24 (2.9%) nonfatal myocardial infarctions and 63 (8%) hospital readmissions for unstable angina. One hundred seventy-four patients (22%) underwent coronary revascularization (bypass surgery or coronary angioplasty). Spontaneous events occurred in 61 of 436 patients with positive and 40 of 342 patients with negative findings on dobutamine-atropine stress echocardiography (14% vs. 12%, p = 0.3). When only spontaneously occurring events were considered, the most important predictor was myocardial viability (chi-square 9.7). Using the Cox proportional hazards model, only the presence of myocardial viability (hazard ratio [HR] 2.0, p < 0.002) and age (HR 1.03, p < 0.001) were predictive of spontaneously occurring events. When only hard cardiac events were considered, age was the strongest predictor (chi-square 3.6, p = 0.056), followed by wall motion score index (WMSI) at peak dose (chi-square 3.3, p = 0.06) and remote ischemia (chi-square 2.25, p = 0.1). When cardiac death was considered, WMSI at peak dose was the best predictor (HR 9.2, p < 0.0001)., Conclusions: During dobutamine stress, echocardiographic recognition of myocardial viability is more prognostically important than echocardiographic recognition of myocardial ischemia for predicting unstable angina, whereas WMSI at peak stress was the best predictor of cardiac-related death. Different events can be recognized with different efficiency by various stress echocardiographic variables.
Published: 1997
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35. [Acute ischemia in myocardial hypertrophy: a report of 2 clinical cases].

Author: Dodi C, Lazzeroni E, Iori E, and Bruno G
Subjects: Acute Disease, Echocardiography, Electrocardiography, Female, Humans, Hypertension complications, Hypertension diagnosis, Hypertrophy, Left Ventricular diagnosis, Male, Middle Aged, Myocardial Ischemia diagnosis, Hypertrophy, Left Ventricular complications, Myocardial Ischemia etiology
Abstract: We report two cases presented with a clinical picture of acute myocardial ischemia, chest pain and giant negative T waves on electrocardiogram (absent in previous tracings). The echocardiogram B-Mode showed in both cases an asymmetric left ventricular hypertrophy caused, respectively, by hypertrophic cardiomyopathy and hypertensive heart disease. Short-term electrocardiographic evolution to complete normalization was observed in both cases. The echo-dipyridamole test did not show dissynergias and this fact suggested the absence of coronary artery disease; this hypothesis was confirmed by a normal coronary angiography. We suppose that in both patients a few factors contributed to the ischemic events: respectively an acute anemia due to gastric bleeding and high blood pressure values. This clinical presentation is an example of a difficult differential diagnostic problem between left ventricular hypertrophy and acute myocardial ischemia, as it shows that giant negative T waves in hypertrophic cardiomyopathy do not necessarily depend on left myocardial hypertrophy involving the apex or other segments but may be associated to an acute myocardial ischemia related or not to a coronary artery disease. A correct evaluation of these clinical cases is important for clinical, therapeutic and prognostic implications.
Published: 1995

36. Severity of arrhythmias and extent of hypertrophy in hypertrophic cardiomyopathy.

Author: Lazzeroni E, Domenicucci S, Finardi A, Zoni A, Dodi C, Francescon P, and Botti G
Subjects: Adolescent, Adult, Aged, Arrhythmias, Cardiac epidemiology, Cardiomegaly pathology, Cardiomyopathy, Hypertrophic mortality, Cardiomyopathy, Hypertrophic pathology, Echocardiography, Electrocardiography, Electrocardiography, Ambulatory, Female, Humans, Male, Middle Aged, Severity of Illness Index, Arrhythmias, Cardiac physiopathology, Cardiomyopathy, Hypertrophic physiopathology
Abstract: To evaluate the relationship between the extent of left ventricular hypertrophy and ventricular or atrial arrhythmias, 77 patients with hypertrophic cardiomyopathy underwent two-dimensional echocardiography and 24-hour Holter monitoring. Antiarrhythmic treatment was discontinued before the study. Hypertrophy was septal in 33 patients, "extensive" (i.e., involving the septum and free wall) in 38 patients, and predominantly apical in six patients. Lown grade I and II ventricular arrhythmias were detected in 37% of patients, grade III in 21%, and grade IV in 29%. Atrial extrasystoles were seen in 52% of patients and chronic atrial fibrillation in 13%. More serious ventricular arrhythmias (Lown grades III and IV) occurred significantly more frequently in patients with extensive than in those with only septal hypertrophy (22/38 vs 11/33; p less than 0.001); similarly, chronic atrial fibrillation occurred more commonly in those with extensive hypertrophy (9/38 vs 1/33; p less than 0.01). During a mean follow-up period of 2.6 years, three patients died. All had a pattern of extensive hypertrophy. Two of them had ventricular tachycardia and the third had chronic atrial fibrillation. Results of this study suggest that an echocardiographic finding of extensive hypertrophy represents a useful marker for detecting patients at increased risk for serious ventricular and atrial arrhythmias.
Published: 1989
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37. [Volume and left ventricular mass in idiopathic dilated cardiomyopathy].

Author: Dodi C, Quinto Villani G, Rosi A, Gandolfini A, Zoni A, and Botti G
Subjects: Adult, Cardiomyopathy, Dilated physiopathology, Echocardiography, Female, Follow-Up Studies, Heart Ventricles pathology, Humans, Male, Middle Aged, Myocardial Contraction, Cardiomyopathy, Dilated pathology
Published: 1987

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