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2. Pulmonary Congestion During Exercise Stress Echocardiography in Ischemic and Heart Failure Patients

Author

Merli, Elisa, Ciampi, Quirino, Scali, Maria Chiara, Zagatina, Angela, Merlo, Pablo Martin, Arbucci, Rosina, Daros, Clarissa Borguezan, de Castro e Silva Pretto, José Luis, Amor, Miguel, Salamè, Michael F., Mosto, Hugo, Morrone, Doralisa, D’Andrea, Antonello, Reisenhofer, Barbara, Rodriguez-Zanella, Hugo, Wierzbowska-Drabik, Karina, Kasprzak, Jaroslaw D., Agoston, Gergely, Varga, Albert, Lowenstein, Jorge, Dodi, Claudio, Cortigiani, Lauro, Simova, Iana, Samardjieva, Martina, Citro, Rodolfo, Celutkiene, Jelena, Re, Federica, Monte, Ines, Gligorova, Suzana, Antonini-Canterin, Francesco, Pepi, Mauro, Carpeggiani, Clara, Pellikka, Patricia A., and Picano, Eugenio

Published
2022
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3. Functional, Anatomical, and Prognostic Correlates of Coronary Flow Velocity Reserve During Stress Echocardiography

Author

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

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

Author

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

Published
2017
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5. Lung Ultrasound and Pulmonary Congestion During Stress Echocardiography

Author

Scali, Maria Chiara, primary, Zagatina, Angela, additional, Ciampi, Quirino, additional, Cortigiani, Lauro, additional, D'Andrea, Antonello, additional, Daros, Clarissa Borguezan, additional, Zhuravskaya, Nadezhda, additional, Kasprzak, Jaroslaw D., additional, Wierzbowska-Drabik, Karina, additional, Luis de Castro e Silva Pretto, José, additional, Djordjevic-Dikic, Ana, additional, Beleslin, Branko, additional, Petrovic, Marija, additional, Boskovic, Nikola, additional, Tesic, Milorad, additional, Monte, Ines, additional, Simova, Iana, additional, Vladova, Martina, additional, Boshchenko, Alla, additional, Vrublevsky, Alexander, additional, Citro, Rodolfo, additional, Amor, Miguel, additional, Vargas Mieles, Paul E., additional, Arbucci, Rosina, additional, Merlo, Pablo Martin, additional, Lowenstein Haber, Diego M., additional, Dodi, Claudio, additional, Rigo, Fausto, additional, Gligorova, Suzana, additional, Dekleva, Milica, additional, Severino, Sergio, additional, Lattanzi, Fabio, additional, Morrone, Doralisa, additional, Galderisi, Maurizio, additional, Torres, Marco A.R., additional, Salustri, Alessandro, additional, Rodrìguez-Zanella, Hugo, additional, Costantino, Fabio Marco, additional, Varga, Albert, additional, Agoston, Gergely, additional, Bossone, Eduardo, additional, Ferrara, Francesco, additional, Gaibazzi, Nicola, additional, Celutkiene, Jelena, additional, Haberka, Maciej, additional, Mori, Fabio, additional, D'Alfonso, Maria Grazia, additional, Reisenhofer, Barbara, additional, Camarozano, Ana Cristina, additional, Miglioranza, Marcelo Haertel, additional, Szymczyk, Ewa, additional, Wejner-Mik, Paulina, additional, Wdowiak-Okrojek, Katarzyna, additional, Preradovic-Kovacevic, Tamara, additional, Bombardini, Tonino, additional, Ostojic, Miodrag, additional, Nikolic, Aleksandra, additional, Re, Federica, additional, Barbieri, Andrea, additional, Di Salvo, Giovanni, additional, Merli, Elisa, additional, Colonna, Paolo, additional, Lorenzoni, Valentina, additional, De Nes, Michele, additional, Paterni, Marco, additional, Carpeggiani, Clara, additional, Lowenstein, Jorge, additional, and Picano, Eugenio, additional

Published
2020
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6. The Functional Meaning of B-Profile During Stress Lung Ultrasound

Author

Scali, Maria Chiara, primary, Zagatina, Angela, additional, Ciampi, Quirino, additional, Cortigiani, Lauro, additional, D'Andrea, Antonello, additional, Djordjevic-Dikic, Ana, additional, Merlo, Pablo Martin, additional, Lattanzi, Fabio, additional, Simova, Iana, additional, Monte, Ines, additional, Dodi, Claudio, additional, Kasprzak, Jaroslaw D., additional, Galderisi, Maurizio, additional, Boshchenko, Alla, additional, Rigo, Fausto, additional, Varga, Albert, additional, Dekleva, Milica, additional, Re, Federica, additional, de Castro e Silva Pretto, José Luis, additional, Zhuravaskaya, Nadezhda, additional, Wierzbowska-Drabik, Karina, additional, Coviello, Katia, additional, Citro, Rodolfo, additional, Colonna, Paolo, additional, Carpeggiani, Clara, additional, and Picano, Eugenio, additional

Published
2019
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8. Hemodynamic Heterogeneity of Reduced Cardiac Reserve Unmasked by Volumetric Exercise Echocardiography.

Author

Bombardini, Tonino, Zagatina, Angela, Ciampi, Quirino, Arbucci, Rosina, Merlo, Pablo Martin, Haber, Diego M. Lowenstein, Morrone, Doralisa, D'Andrea, Antonello, Djordjevic-Dikic, Ana, Beleslin, Branko, Tesic, Milorad, Boskovic, Nikola, Giga, Vojislav, de Castro e Silva Pretto, José Luis, Daros, Clarissa Borguezan, Amor, Miguel, Mosto, Hugo, Salamè, Michael, Monte, Ines, and Citro, Rodolfo

Subjects
CORONARY artery disease, STRESS echocardiography, HEMODYNAMICS, ECHOCARDIOGRAPHY, SYSTOLIC blood pressure
Abstract

Background: Two-dimensional volumetric exercise stress echocardiography (ESE) provides an integrated view of left ventricular (LV) preload reserve through end-diastolic volume (EDV) and LV contractile reserve (LVCR) through end-systolic volume (ESV) changes. Purpose: To assess the dependence of cardiac reserve upon LVCR, EDV, and heart rate (HR) during ESE. Methods: We prospectively performed semi-supine bicycle or treadmill ESE in 1344 patients (age 59.8 ± 11.4 years; ejection fraction = 63 ± 8%) referred for known or suspected coronary artery disease. All patients had negative ESE by wall motion criteria. EDV and ESV were measured by biplane Simpson rule with 2-dimensional echocardiography. Cardiac index reserve was identified by peak-rest value. LVCR was the stress-rest ratio of force (systolic blood pressure by cuff sphygmomanometer/ESV, abnormal values ≤2.0). Preload reserve was defined by an increase in EDV. Cardiac index was calculated as stroke volume index * HR (by EKG). HR reserve (stress/rest ratio) <1.85 identified chronotropic incompetence. Results: Of the 1344 patients, 448 were in the lowest tertile of cardiac index reserve with stress. Of them, 303 (67.6%) achieved HR reserve <1.85; 252 (56.3%) had an abnormal LVCR and 341 (76.1%) a reduction of preload reserve, with 446 patients (99.6%) showing ≥1 abnormality. At binary logistic regression analysis, reduced preload reserve (odds ratio [OR]: 5.610; 95% confidence intervals [CI]: 4.025 to 7.821), chronotropic incompetence (OR: 3.923, 95% CI: 2.915 to 5.279), and abnormal LVCR (OR: 1.579; 95% CI: 1.105 to 2.259) were independently associated with lowest tertile of cardiac index reserve at peak stress. Conclusions: Heart rate assessment and volumetric echocardiography during ESE identify the heterogeneity of hemodynamic phenotypes of impaired chronotropic, preload or LVCR underlying a reduced cardiac reserve. [ABSTRACT FROM AUTHOR]

Published
2021
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9. 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

10. The Functional Meaning of B-Profile During Stress Lung Ultrasound

Author

Angela Zagatina, Antonello D'Andrea, Milica Dekleva, Fabio Lattanzi, Paolo Colonna, Maurizio Galderisi, Ana Djordjevic-Dikic, Nadezhda Zhuravaskaya, Federica Re, Alla A. Boshchenko, Quirino Ciampi, Ines Monte, Katia Coviello, Maria Chiara Scali, Pablo Merlo, Eugenio Picano, Albert Varga, Rodolfo Citro, Clara Carpeggiani, Iana Simova, Claudio Dodi, Lauro Cortigiani, Fausto Rigo, José Luis de Castro e Silva Pretto, Jarosław D. Kasprzak, Karina Wierzbowska-Drabik, Scali, Maria Chiara, Zagatina, Angela, Ciampi, Quirino, Cortigiani, Lauro, D'Andrea, Antonello, Djordjevic-Dikic, Ana, Merlo, Pablo Martin, Lattanzi, Fabio, Simova, Iana, Monte, Ine, Dodi, Claudio, Kasprzak, Jaroslaw D, Galderisi, Maurizio, Boshchenko, Alla, Rigo, Fausto, Varga, Albert, Dekleva, Milica, Re, Federica, de Castro E Silva Pretto, José Lui, Zhuravaskaya, Nadezhda, Wierzbowska-Drabik, Karina, Coviello, Katia, Citro, Rodolfo, Colonna, Paolo, Carpeggiani, Clara, and Picano, Eugenio

Subjects
Male, medicine.medical_specialty, Vasodilator Agents, Myocardial Ischemia, Pulmonary Edema, 030204 cardiovascular system & hematology, stress echo, 030218 nuclear medicine & medical imaging, Coronary artery disease, B-lines, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Prospective cohort study, Lung, Aged, business.industry, Ultrasound, Middle Aged, medicine.disease, Lung ultrasound, Normal lung, Heart failure, Cardiology, Exercise Test, Female, Pulmonary congestion, Exercise stress echocardiography, B-lines, stress echo, Cardiology and Cardiovascular Medicine, business, Echocardiography, Stress
Abstract

The B-Profile of normal lung sliding with B-lines by lung ultrasound (LUS) identifies pulmonary congestion at rest and during exercise stress echocardiography (SE) in coronary artery disease (CAD) [(1)][1] or heart failure (HF) patients with either reduced [(2)][2] or preserved [(3)][3] resting

Published
2018

11. Quality control of regional wall motion analysis in stress Echo 2020

Author

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

Subjects
Quality Control, medicine.medical_specialty, Certification, Internationality, media_common.quotation_subject, Control (management), Coronary Disease, Quality control, Stress echocardiography, Wall motion, Cardiologists, Clinical Competence, Echocardiography, Stress, Humans, Reproducibility of Results, Audit, 030204 cardiovascular system & hematology, Stress, Credentialing, Session (web analytics), 03 medical and health sciences, 0302 clinical medicine, Reading (process), medicine, Quality (business), Medical physics, 030212 general & internal medicine, Set (psychology), media_common, business.industry, Cardiology and Cardiovascular Medicine, Gold standard, Echocardiography, Radiology, business
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 videoclips 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 31 years (mean value 18 years). 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. (C) 2017 Elsevier B.V. All rights reserved.

Published
2017

12. Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes.

Author

Morrone D, Arbucci R, Wierzbowska-Drabik K, Ciampi Q, Peteiro J, Agoston G, Varga A, Camarozano AC, Boshchenko A, Ryabova T, Dekleva M, Simova I, Lowenstein Haber DM, Tesic M, Boskovic N, Djordjevic-Dikic A, Beleslin B, D'Alfonso MG, Mori F, Rodrìguez-Zanella H, Kasprzak JD, Cortigiani L, Lattanzi F, Scali MC, Torres MAR, Daros CB, de Castro E Silva Pretto JL, Gaibazzi N, Zagatina A, Zhuravskaya N, Amor M, Mieles PEV, Merlo PM, Monte I, D'Andrea A, Re F, Di Salvo G, Merli E, Lorenzoni V, De Nes M, Paterni M, Limongelli G, Prota C, Citro R, Colonna P, Villari B, Antonini-Canterin F, Carpeggiani C, Lowenstein J, and Picano E

Subjects
Adrenergic beta-1 Receptor Agonists administration & dosage, Aged, Aged, 80 and over, Argentina, Brazil, Chronic Disease, Coronary Artery Disease physiopathology, Europe, Exercise, Feasibility Studies, Female, Heart Atria physiopathology, Humans, Italy, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Syndrome, Vasodilator Agents administration & dosage, Atrial Function, Left, Atrial Pressure, Coronary Artery Disease diagnostic imaging, Echocardiography, Doppler, Pulsed, Echocardiography, Stress, Heart Atria diagnostic imaging
Abstract

An enlarged left atrial volume index (LAVI) at rest mirrors increased LA pressure and/or impairment of LA function. A cardiovascular stress may acutely modify left atrial volume (LAV) within minutes. Aim of this study was to assess the feasibility and functional correlates of LAV-stress echocardiography (SE) Out of 514 subjects referred to 10 quality-controlled labs, LAV-SE was completed in 490 (359 male, age 67 ± 12 years) with suspected or known chronic coronary syndromes (n = 462) or asymptomatic controls (n = 28). The utilized stress was exercise in 177, vasodilator in 167, dobutamine in 146. LAV was measured with the biplane disk summation method. SE was performed with the ABCDE protocol. The intra-observer and inter-observer LAV variability were 5% and 8%, respectively. ∆-LAVI changes (stress-rest) were negatively correlated with resting LAVI (r = - 0.271, p < 0.001) and heart rate reserve (r = -.239, p < 0.001). LAV-dilators were defined as those with stress-rest increase ≥ 6.8 ml/m 2 , a cutoff derived from a calculated reference change value above the biological, analytical and observer variability of LAVI. LAV dilation occurred in 56 patients (11%), more frequently with exercise (16%) and dipyridamole (13%) compared to dobutamine (4%, p < 0.01). At multivariable logistic regression analysis, B-lines ≥ 2 (OR: 2.586, 95% CI = 1.1293-5.169, p = 0.007) and abnormal contractile reserve (OR: 2.207, 95% CI = 1.111-4.386, p = 0.024) were associated with LAV dilation. In conclusion, LAV-SE is feasible with high success rate and low variability in patients with chronic coronary syndromes. LAV dilation is more likely with reduced left ventricular contractile reserve and pulmonary congestion.

Published
2021
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