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2. PROTEUS Study: A Prospective Randomized Controlled Trial Evaluating the Use of Artificial Intelligence in Stress Echocardiography

Author

Woodward, Gary, Bajre, Mamta, Bhattacharyya, Sanjeev, Breen, Maria, Chiocchia, Virginia, Dawes, Helen, Dehbi, Hakim-Moulay, Descamps, Tine, Frangou, Elena, Fazakarley, Carol-Ann, Harris, Victoria, Hawkes, Will, Hewer, Oliver, Johnson, Casey L, Krasner, Samuel, Laidlaw, Lynn, Lau, Jonathan, Marwick, Tom, Petersen, Steffen E, Piotrowska, Hania, Ridgeway, Ged, Ripley, David P, Sanderson, Emily, Savage, Natalie, Sarwar, Rizwan, Tetlow, Louise, Thompson, Ben, Thulborn, Samantha, Williamson, Victoria, Woodward, William, Upton, Ross, and Leeson, Paul

Published
2023
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3. Automated Echocardiographic Detection of Heart Failure With Preserved Ejection Fraction Using Artificial Intelligence

Author

Akerman, Ashley P., Porumb, Mihaela, Scott, Christopher G., Beqiri, Arian, Chartsias, Agisilaos, Ryu, Alexander J., Hawkes, William, Huntley, Geoffrey D., Arystan, Ayana Z., Kane, Garvan C., Pislaru, Sorin V., Lopez-Jimenez, Francisco, Gomez, Alberto, Sarwar, Rizwan, O'Driscoll, Jamie, Leeson, Paul, Upton, Ross, Woodward, Gary, and Pellikka, Patricia A.

Published
2023
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4. Human versus Artificial Intelligence–Based Echocardiographic Analysis as a Predictor of Outcomes: An Analysis from the World Alliance Societies of Echocardiography COVID Study

Author

Munoz, Vince Ryan V., De Marchi, Rafael Porto, Alday-Ramirez, Sergio M., Orihuela, Consuelo, Sadeghpour, Anita, Breeze, Jonathan, Hoare, Amy, Rosales, Carlos Ixcanparij, Cohen, Ariel, Milani, Martina, Trolese, Ilaria, Belli, Oriana, De Chiara, Benedetta, Bellino, Michele, Iuliano, Giuseppe, Yang, Yun, Asch, Federico M., Descamps, Tine, Sarwar, Rizwan, Karagodin, Ilya, Singulane, Cristiane Carvalho, Xie, Mingxing, Tucay, Edwin S., Tude Rodrigues, Ana C., Vasquez-Ortiz, Zuilma Y., Monaghan, Mark J., Ordonez Salazar, Bayardo A., Soulat-Dufour, Laurie, Alizadehasl, Azin, Mostafavi, Atoosa, Moreo, Antonella, Citro, Rodolfo, Narang, Akhil, Wu, Chun, Addetia, Karima, Upton, Ross, Woodward, Gary M., and Lang, Roberto M.

Published
2022
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5. Abstract 17227: An Artificial Intelligence Based Model for Heart Failure With Preserved Ejection Fraction Predicts Cardiac Mortality

Author

Cassianni, Claire E, Huntley, Geoffrey D, Akerman, Ashley P, Porumb, Mihaela, Scott, Christopher G, Chartsias, Agisilaos, Ryu, Alexander J, Hawkes, William, Arystan, Ayana Z, Kane, Garvan C, Pislaru, Sorin V, Lopez-Jimenez, Francisco, Sarwar, Rizwan, OʼDriscoll, Jamie, Leeson, Paul, Upton, Ross, woodward, gary, and Pellikka, Patricia A

Published
2023
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6. Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study.

Author

Woodward, William, Johnson, Casey L, Krasner, Samuel, O'Driscoll, Jamie, McCourt, Annabelle, Dockerill, Cameron, Balkhausen, Katrin, Chandrasekaran, Badrinathan, Firoozan, Soroosh, Kardos, Attila, Sabharwal, Nikant, Sarwar, Rizwan, Senior, Roxy, Sharma, Rajan, Wong, Kenneth, Augustine, Daniel X, and Leeson, Paul

Subjects
MYOCARDIAL infarction risk factors, NATIONAL health services, CHEST pain, RESEARCH funding, MYOCARDIAL ischemia, TREATMENT effectiveness, DESCRIPTIVE statistics, LONGITUDINAL method, KAPLAN-Meier estimator, CONFIDENCE intervals, ECHOCARDIOGRAPHY, PROPORTIONAL hazards models
Abstract

Aims Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result to inform on likely longer-term outcomes when applied in real-world practice across a healthcare system has not been previously reported. Methods and results Five thousand five hundred and three patients recruited across 32 UK NHS hospitals between 2018 and 2022, participating in the EVAREST/BSE-NSTEP prospective cohort study, with data on medical outcomes up to 2023 available from NHS England were included in the analysis. Stress echocardiography results were related to outcomes, including death, procedures, hospital admissions, and relevant cardiovascular diagnoses, based on Kaplan–Meier analysis and Cox proportional hazard ratios (HRs). Median follow-up was 829 days (interquartile range 224–1434). A positive stress echocardiogram was associated with a greater risk of myocardial infarction [HR 2.71, 95% confidence interval (CI) 1.73–4.24, P < 0.001] and a composite endpoint of cardiac-related mortality and myocardial infarction (HR 2.03, 95% CI 1.41–2.93, P < 0.001). Hazard ratios increased with ischaemic burden. A negative stress echocardiogram identified an event-free 'warranty period' of at least 5 years in patients with no prior history of coronary artery disease and 4 years for those with disease. Conclusion In real-world practice, the degree of myocardial ischaemia recorded by clinicians at stress echocardiography correctly categorizes risk of future events over the next 5 years. Reporting a stress echocardiogram as negative correctly identifies patients with no greater than a background risk of cardiovascular events over a similar time period. [ABSTRACT FROM AUTHOR]

Published
2025
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7. Automated Echocardiographic Detection of Severe Coronary Artery Disease Using Artificial Intelligence

Author

Upton, Ross, Mumith, Angela, Beqiri, Arian, Parker, Andrew, Hawkes, William, Gao, Shan, Porumb, Mihaela, Sarwar, Rizwan, Marques, Patricia, Markham, Deborah, Kenworthy, Jake, O’Driscoll, Jamie M., Hassanali, Neelam, Groves, Kate, Dockerill, Cameron, Woodward, William, Alsharqi, Maryam, McCourt, Annabelle, Wilkes, Edmund H., Heitner, Stephen B., Yadava, Mrinal, Stojanovski, David, Lamata, Pablo, Woodward, Gary, and Leeson, Paul

Published
2022
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8. Ventricular Changes in Patients with Acute COVID-19 Infection: Follow-up of the World Alliance Societies of Echocardiography (WASE-COVID) Study

Author

Munoz, Vince Ryan V., De Marchi, Rafael Porto, Alday-Ramirez, Sergio M., Orihuela, Consuelo, Sadeghpour, Anita, Breeze, Jonathan, Hoare, Amy, Rosales, Carlos Ixcanparij, Cohen, Ariel, Milani, Martina, Trolese, Ilaria, Belli, Oriana, De Chiara, Benedetta, Bellino, Michele, Iuliano, Giuseppe, Yang, Yun, Karagodin, Ilya, Singulane, Cristiane Carvalho, Descamps, Tine, Woodward, Gary M., Xie, Mingxing, Tucay, Edwin S., Sarwar, Rizwan, Vasquez-Ortiz, Zuilma Y., Alizadehasl, Azin, Monaghan, Mark J., Ordonez Salazar, Bayardo A., Soulat-Dufour, Laurie, Mostafavi, Atoosa, Moreo, Antonella, Citro, Rodolfo, Narang, Akhil, Wu, Chun, Addetia, Karima, Tude Rodrigues, Ana C., Lang, Roberto M., and Asch, Federico M.

Published
2022
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9. PROTEUS: A Prospective RCT Evaluating Use of AI in Stress Echocardiography.

Author

Upton, Ross, Akerman, Ashley P., Marwick, Thomas H., Johnson, Casey L., Piotrowska, Hania, Bajre, Mamta, Breen, Maria, Dawes, Helen, Dehbi, Hakim-Moulay, Descamps, Tine, Harris, Victoria, Hawkes, Will, Krasner, Samuel, Sanderson, Emily, Savage, Natalie, Thompson, Ben, Williamson, Victoria, Woodward, William, Sarwar, Rizwan, and O'Driscoll, Jamie

Subjects
ARTIFICIAL intelligence, CARDIOVASCULAR diseases, ECHOCARDIOGRAPHY, CORONARY angiography, MEDICAL care
Abstract

BACKGROUND Use of artificial intelligence (AI) in cardiovascular imaging may potentially augment clinical decision-making in disease management, but no prospective randomized controlled trials have assessed the impact on cardiovascular outcomes. This study evaluates whether AI-augmented decision-making is non-inferior to standard decision-making when selecting participants for invasive coronary angiography following stress echocardiography. METHODS PROTEUS was a multicenter, parallel-group randomized controlled trial. We enrolled participants undergoing a stress echocardiogram at 20 centers across the United Kingdom between November 2021 and June 2023. Participants were randomly assigned to standard clinical decision-making (control) or decision-making augmented by AI (intervention). The primary end point was appropriate referral for coronary angiography, with true positives defined as severe coronary disease requiring revascularization in participants referred for invasive angiography and false negatives defined as an acute coronary event within 6 months. Secondary analysis examined intervention versus control in prespecified subgroups where interpretation is known to be more challenging. RESULTS Out of 2341 randomly assigned participants, 2213 (94.53%) completed 6 months' follow-up. Eighty-five participants were referred for angiography, 61 of whom had significant coronary disease. Of the participants not referred, 41 participants had acute coronary syndrome or died within 6 months. The difference between the area under the receiver operating characteristic curve (AUROC) for the intervention (0.63; 95% confidence interval (CI), 0.43 to 0.83) and control (0.55; 95% CI, 0.33 to 0.80), did not meet the prespecified non-inferiority margin of -0.05 (difference, 0.09; 95% CI, -0.22 to 0. 39). The sensitivity in the intervention (64.2%; 95% CI, 33.3 to 80.0%) and control (55.1%; 95% CI, 43.7 to 84.2%) was similar (difference, 9.1%; 95% CI, -21.8 to 39.6%). Likewise, the specificity in the intervention (98.6%; 95% CI, 98.1 to 99.8%) and control (99.2%; 95% CI, 97.2 to 99.5%) was similar (difference, 0.6%; 95% CI, -2.1 to 0.9%). Subgroup analyses suggest potential benefit of AI-augmentation in low-volume stress echocardiography centers. CONCLUSIONS AI-augmented decision-making in stress echocardiography did not meet the non-inferiority end point when evaluated in a large, prospective randomized controlled trial, but may be beneficial in low-volume centers. (Funded by the Accelerated Access Collaborative and others; ClinicalTrials.gov number, NCT05028179; ISRCTN number, ISRCTN15113915. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Characterization, anti‐microbial, anti‐oxidant and growth promoting effects of biogenically synthesized silver nanoparticles derived from Dicliptera bupleuroides Nees.

Author

Samad, Memoona, Akhtar, Wasim, Muneer, Arooj, Fatima, Iram, Manzoor, Muhammad, Gillani, Syed Waseem, Rehman, Fazal Ur, Majeed, Khawar, Ali, Baber, and Sarwar, Rizwan

Abstract

One of the most important areas of nanotechnology is the use of nanoparticles (NPs) for a variety of environmental and biological applications, with silver nanoparticles (Ag‐NPs) gaining a lot attention due to their distinct properties. The current study deals with the synthesis of Ag‐NPs from Dicliptera bupleuroides Nees leaf extract and to determine their antioxidant, antimicrobial potential and effects on wheat seed germination and growth. UV–Visible spectrum revealed a prominent absorption peak at 442 nm, elucidating the conformation of the Ag‐NPs synthesis. Scanning electron microscopy (SEM) showed distinctive triangular, pyramidal, and irregular shape. X‐ray diffraction (XRD) demonstrated their crystalline nature, with average crystallite size of the Ag‐NPs measured at 20.52 nm. Fourier‐transform infrared spectroscopy (FT‐IR) further confirmed the presence of functional groups such as Phenols (O‐H stretch), transition metal carbonyls N‐H, ≡C‐H, C ≡ N, C ≡ C, C‐Cl, C‐Br and O‐H bonds on the surface Ag‐NPs. The antibacterial activity of the Ag‐NPs was most pronounced against Bacillus subtilis, with a zone of inhibition (ZOI) measuring 11 mm ± 0.57 at a concentration of 1000 μg/mL (45% inhibition). Likewise, Ag‐NPs exhibited highest antioxidant potential (73.2%) at 100 μg/mL compared with standard (ascorbic acid) which showed (76%) at the same concentration. Furthermore, the effect of D. bupleuroides mediated Ag‐NPs on wheat seeds growth and germination was recorded maximum at high concentrations (200‐300 ppm). In conclusion, D. bupleuroides mediated Ag‐NPs showed safe, cost effective and environmentally friendly synthesis which can be used as an antibacterial and antioxidant agent as well as for enhancing the growth and seed germination of crop seeds globally. Research Highlights: Nanotechnology is the study of nanoparticles for biological and environmental applications.Ag‐NPs among other NPs have received broad attention because of their unique properties.D. bupleuroides Ag‐NPs: 45% antibacterial, 73.2% antioxidant, enhance wheat germination.D. bupleuroides‐mediated Ag‐NPs are both cost‐effective and environmentally beneficial. [ABSTRACT FROM AUTHOR]

Published
2024
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13. Clinical Utility Of An AI-Based Model For Detection Of Heart Failure With Preserved Ejection Fraction Using Decision Curve Analysis

Author

Upton, Ross, primary, Akerman, Ashley P., additional, Porumb, Mihaela, additional, Scott, Christopher G., additional, Beqiri, Arian, additional, Chartsias, Agisilaos, additional, Ryu, Alexander, additional, Hawkes, William, additional, Huntley, Geoffrey, additional, Arystan, Ayana, additional, Kane, Garvan, additional, Pislaru, Sorin, additional, Lopez-Jimenez, Francisco, additional, Sarwar, Rizwan, additional, O'Driscoll, Jamie, additional, Leeson, Paul, additional, Woodward, Gary, additional, and Pellikka, Patricia A., additional

Published
2024
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14. A guideline update for the practice of echocardiography in the cardiac screening of sports participants: a joint policy statement from the British Society of Echocardiography and Cardiac Risk in the Young

Author

Oxborough, David, Augustine, Daniel, Gati, Sabiha, George, Keith, Harkness, Allan, Mathew, Thomas, Papadakis, Michael, Ring, Liam, Robinson, Shaun, Sandoval, Julie, Sarwar, Rizwan, Sharma, Sanjay, Sharma, Vishal, Sheikh, Nabeel, Somauroo, John, Stout, Martin, Willis, James, and Zaidi, Abbas

Published
2018
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15. COMPARISON OF CLINICAL ALGORITHMS AND ARTIFICIAL INTELLIGENCE APPLIED TO AN ECHOCARDIOGRAM TO CATEGORIZE RISK OF HEART FAILURE WITH PRESERVED EJECTION FRACTION (HFPEF)

Author

Akerman, Ashley, primary, Porumb, Mihaela, additional, Beqiri, Arian, additional, Chartsias, Agisilaos, additional, Scott, Christopher, additional, Ryu, Alexander, additional, Kane, Garvan C., additional, Pislaru, Sorin, additional, Lopez-Jimenez, Francisco, additional, Sarwar, Rizwan, additional, Leeson, Paul, additional, Upton, Ross, additional, Woodward, Gary, additional, and Pellikka, Patricia A., additional

Published
2023
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16. Human versus Artificial Intelligence–Based Echocardiographic Analysis as a Predictor of Outcomes: An Analysis from the World Alliance Societies of Echocardiography COVID Study

Author

Asch, Federico M., primary, Descamps, Tine, additional, Sarwar, Rizwan, additional, Karagodin, Ilya, additional, Singulane, Cristiane Carvalho, additional, Xie, Mingxing, additional, Tucay, Edwin S., additional, Tude Rodrigues, Ana C., additional, Vasquez-Ortiz, Zuilma Y., additional, Monaghan, Mark J., additional, Ordonez Salazar, Bayardo A., additional, Soulat-Dufour, Laurie, additional, Alizadehasl, Azin, additional, Mostafavi, Atoosa, additional, Moreo, Antonella, additional, Citro, Rodolfo, additional, Narang, Akhil, additional, Wu, Chun, additional, Addetia, Karima, additional, Upton, Ross, additional, Woodward, Gary M., additional, Lang, Roberto M., additional, Munoz, Vince Ryan V., additional, De Marchi, Rafael Porto, additional, Alday-Ramirez, Sergio M., additional, Orihuela, Consuelo, additional, Sadeghpour, Anita, additional, Breeze, Jonathan, additional, Hoare, Amy, additional, Rosales, Carlos Ixcanparij, additional, Cohen, Ariel, additional, Milani, Martina, additional, Trolese, Ilaria, additional, Belli, Oriana, additional, De Chiara, Benedetta, additional, Bellino, Michele, additional, Iuliano, Giuseppe, additional, and Yang, Yun, additional

Published
2022
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17. Left ventricular assessment with artificial intelligence increases the diagnostic accuracy of stress echocardiography

Author

O’Driscoll, Jamie M, primary, Hawkes, William, additional, Beqiri, Arian, additional, Mumith, Angela, additional, Parker, Andrew, additional, Upton, Ross, additional, McCourt, Annabelle, additional, Woodward, William, additional, Dockerill, Cameron, additional, Sabharwal, Nikant, additional, Kardos, Attila, additional, Augustine, Daniel X, additional, Balkhausen, Katrin, additional, Chandrasekaran, Badrinathan, additional, Firoozan, Soroosh, additional, Marciniak, Anna, additional, Heitner, Stephen, additional, Yadava, Mrinal, additional, Kaul, Sanjiv, additional, Sarwar, Rizwan, additional, Sharma, Rajan, additional, Woodward, Gary, additional, and Leeson, Paul, additional

Published
2022
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18. FULLY AUTOMATED CONTOURING OF CONTRAST ENHANCED ECHOCARDIOGRAMS IN CANCER THERAPY-RELATED CARDIAC DYSFUNCTION IS FEASIBLE AND PRECISE

Author

Akerman, Ashley, primary, Bernard, Lori, additional, Deschamps, Tine, additional, Foster, Bernadette, additional, Hawkes, Will, additional, Mirhadi, Eila, additional, Piotrowska, Hania, additional, Sarwar, Rizwan, additional, Tetlow, Louise, additional, Woodward, Gary, additional, and Becher, Harald, additional

Published
2022
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19. Ventricular Changes in Patients with Acute COVID-19 Infection: Follow-up of the World Alliance Societies of Echocardiography (WASE-COVID) Study

Author

Karagodin, Ilya, primary, Singulane, Cristiane Carvalho, additional, Descamps, Tine, additional, Woodward, Gary M., additional, Xie, Mingxing, additional, Tucay, Edwin S., additional, Sarwar, Rizwan, additional, Vasquez-Ortiz, Zuilma Y., additional, Alizadehasl, Azin, additional, Monaghan, Mark J., additional, Ordonez Salazar, Bayardo A., additional, Soulat-Dufour, Laurie, additional, Mostafavi, Atoosa, additional, Moreo, Antonella, additional, Citro, Rodolfo, additional, Narang, Akhil, additional, Wu, Chun, additional, Addetia, Karima, additional, Tude Rodrigues, Ana C., additional, Lang, Roberto M., additional, Asch, Federico M., additional, Munoz, Vince Ryan V., additional, De Marchi, Rafael Porto, additional, Alday-Ramirez, Sergio M., additional, Orihuela, Consuelo, additional, Sadeghpour, Anita, additional, Breeze, Jonathan, additional, Hoare, Amy, additional, Rosales, Carlos Ixcanparij, additional, Cohen, Ariel, additional, Milani, Martina, additional, Trolese, Ilaria, additional, Belli, Oriana, additional, De Chiara, Benedetta, additional, Bellino, Michele, additional, Iuliano, Giuseppe, additional, and Yang, Yun, additional

Published
2022
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22. Fine-Scale Genetic Structure in the United Arab Emirates Reflects Endogamous and Consanguineous Culture, Population History, and Geography

Author

Elliott, Katherine S, primary, Haber, Marc, additional, Daggag, Hinda, additional, Busby, George B, additional, Sarwar, Rizwan, additional, Kennet, Derek, additional, Petraglia, Michael, additional, Petherbridge, Lawrence J, additional, Yavari, Parisa, additional, Heard-Bey, Frauke U, additional, Shobi, Bindu, additional, Ghulam, Tariq, additional, Haj, Dalia, additional, Al Tikriti, Alia, additional, Mohammad, Alshafi, additional, Antony, Suma, additional, Alyileili, Maitha, additional, Alaydaroos, Shatha, additional, Lau, Evelyn, additional, Butler, Mark, additional, Yavari, Arash, additional, Knight, Julian C, additional, Ashrafian, Houman, additional, and Barakat, Maha T, additional

Published
2022
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24. Dysregulated Phenylalanine Catabolism Plays a Key Role in the Trajectory of Cardiac Aging

Author

Czibik, Gabor, primary, Mezdari, Zaineb, additional, Murat Altintas, Dogus, additional, Bréhat, Juliette, additional, Pini, Maria, additional, d’Humières, Thomas, additional, Delmont, Thaïs, additional, Radu, Costin, additional, Breau, Marielle, additional, Liang, Hao, additional, Martel, Cecile, additional, Abatan, Azania, additional, Sarwar, Rizwan, additional, Marion, Ophélie, additional, Naushad, Suzain, additional, Zhang, Yanyan, additional, Halfaoui, Maissa, additional, Suffee, Nadine, additional, Morin, Didier, additional, Adnot, Serge, additional, Hatem, Stéphane, additional, Yavari, Arash, additional, Sawaki, Daigo, additional, and Derumeaux, Geneviève, additional

Published
2021
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25. Left ventricular assessment with artificial intelligence increases the diagnostic accuracy of stress echocardiography.

Author

O'Driscoll, Jamie M., Hawkes, William, Beqiri, Arian, Mumith, Angela, Parker, Andrew, Upton, Ross, McCourt, Annabelle, Woodward, William, Dockerill, Cameron, Sabharwal, Nikant, Kardos, Attila, Augustine, Daniel X., Balkhausen, Katrin, Chandrasekaran, Badrinathan, Firoozan, Soroosh, Marciniak, Anna, Heitner, Stephen, Yadava, Mrinal, Kaul, Sanjiv, and Sarwar, Rizwan

Subjects
LEFT heart ventricle, ARTIFICIAL intelligence, STRESS echocardiography, CORONARY artery disease, ANGIOGRAPHY
Abstract

Aims To evaluate whether left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS), automatically calculated by artificial intelligence (AI), increases the diagnostic performance of stress echocardiography (SE) for coronary artery disease (CAD) detection. Methods and results SEs from 512 participants who underwent a clinically indicated SE (with or without contrast) for the evaluation of CAD from seven hospitals in the UK and US were studied. Visual wall motion scoring (WMS) was performed to identify inducible ischaemia. In addition, SE images at rest and stress underwent AI contouring for automated calculation of AI-LVEF and AI-GLS (apical two and four chamber images only) with Ultromics EchoGo Core 1.0. Receiver operator characteristic curves and multivariable risk models were used to assess accuracy for identification of participants subsequently found to have CAD on angiography. Participants with significant CAD were more likely to have abnormal WMS, AI-LVEF, and AI-GLS values at rest and stress (all P< 0.001). The areas under the receiver operating characteristics for WMS index, AI-LVEF, and AI-GLS at peak stress were 0.92, 0.86, and 0.82, respectively, with cut-offs of 1.12, 64%, and -17.2%, respectively. Multivariable analysis demonstrated that addition of peak AI-LVEF or peak AI-GLS to WMS significantly improved model discrimination of CAD [C-statistic (bootstrapping 2.5th, 97.5th percentile)] from 0.78 (0.69-0.87) to 0.83 (0.74-0.91) or 0.84 (0.75-0.92), respectively. Conclusion AI calculation of LVEF and GLS by contouring of contrast-enhanced and unenhanced SEs at rest and stress is feasible and independently improves the identification of obstructive CAD beyond conventional WMSI. [ABSTRACT FROM AUTHOR]

Published
2022
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27. A trans-acting locus regulates an anti-viral expression network and type 1 diabetes risk

Author

Heinig, Matthias, Petretto, Enrico, Wallace, Chris, Bottolo, Leonardo, Rotival, Maxime, Lu, Han, Li, Yoyo, Sarwar, Rizwan, Langley, Sarah R., Bauerfeind, Anja, Hummel, Oliver, Lee, Young-Ae, Paskas, Svetlana, Rintisch, Carola, Saar, Kathrin, Cooper, Jason, Buchan, Rachel, Gray, Elizabeth E., Cyster, Jason G., Braund, Peter, Gracey, Jay, Krishnan, Unni, Moore, Jasbir S., Nelson, Chris P., Pollard, Helen, Attwood, Tony, Crisp-Hihn, Abi, Foad, Nicola, Jolley, Jennifer, Lloyd-Jones, Heather, Muir, David, Murray, Elizabeth, O’Leary, Karen, Rankin, Angela, Sambrook, Jennifer, Godfroy, Tiphaine, Brocheton, Jessy, Proust, Carole, Schmitz, Gerd, Heimerl, Susanne, Lugauer, Ingrid, Belz, Stephanie, Gulde, Stefanie, Linsel-Nitschke, Patrick, Sager, Hendrik, Schroeder, Laura, Lundmark, Per, Syvannen, Ann-Christine, Neudert, Jessica, Scholz, Michael, Deloukas, Panos, Gray, Emma, Gwilliams, Rhian, Niblett, David, Erdmann, Jeanette, Hengstenberg, Christian, Maouche, Seraya, Ouwehand, Willem H., Rice, Catherine M., Samani, Nilesh J., Schunkert, Heribert, Goodall, Alison H., Schulz, Herbert, Roider, Helge G., Vingron, Martin, Blankenberg, Stefan, Münzel, Thomas, Zeller, Tanja, Szymczak, Silke, Ziegler, Andreas, Tiret, Laurence, Smyth, Deborah J., Pravenec, Michal, Aitman, Timothy J., Cambien, Francois, Clayton, David, Todd, John A., Hubner, Norbert, and Cook, Stuart A.

Published
2010
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28. Real-world performance and accuracy of stress echocardiography: the EVAREST observational multi-centre study.

Author

Woodward, William, Dockerill, Cameron, McCourt, Annabelle, Upton, Ross, O'Driscoll, Jamie, Balkhausen, Katrin, Chandrasekaran, Badrinathan, Firoozan, Soroosh, Kardos, Attila, Wong, Kenneth, Woodward, Gary, Sarwar, Rizwan, Sabharwal, Nikant, Benedetto, Elena, Spagou, Nancy, Sharma, Rajan, Augustine, Daniel, Tsiachristas, Apostolos, Senior, Roxy, and Leeson, Paul

Subjects
ECHOCARDIOGRAPHY, RESEARCH, HOSPITALS, ISCHEMIA, SCIENTIFIC observation, CORONARY artery stenosis, REVASCULARIZATION (Surgery), ACUTE coronary syndrome, CORONARY artery disease, DESCRIPTIVE statistics, ELECTRONIC health records, ANGIOGRAPHY
Abstract

Aims Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography. Methods and results Participants undergoing stress echocardiography for CAD were recruited from 31 hospitals. Participants were followed up through health records which underwent expert adjudication. Cardiac outcome was defined as anatomically or functionally significant stenosis on angiography, revascularization, medical management of ischaemia, acute coronary syndrome, or cardiac-related death within 6 months. A total of 5131 patients (55% male) participated with a median age of 65 years (interquartile range 57–74). 72.9% of studies used dobutamine and 68.5% were contrast studies. Inducible ischaemia was present in 19.3% of scans. Sensitivity and specificity for prediction of a cardiac outcome were 95.4% and 96.0%, respectively, with an accuracy of 95.9%. Sub-group analysis revealed high levels of predictive accuracy across a wide range of patient and protocol sub-groups, with the presence of a resting regional wall motion abnormalitiy significantly reducing the performance of both dobutamine (P  < 0.01) and exercise (P  < 0.05) stress echocardiography. Overall accuracy remained consistently high across all participating hospitals. Conclusion Stress echocardiography has high accuracy across UK-based hospitals and thus indicates stress echocardiography is being delivered effectively in real-world practice, reinforcing its role as a first-line investigation in the assessment of patients with stable chest pain. [ABSTRACT FROM AUTHOR]

Published
2022
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31. Detection of Coronary Stenosis at Rest Using BOLD-CMR

Author

Arnold, J. Ranjit, primary, Jerosch-Herold, Michael, additional, Karamitsos, Theodoros D., additional, Francis, Jane M., additional, Bhamra-Ariza, Paul, additional, Sarwar, Rizwan, additional, Choudhury, Robin, additional, Selvanayagam, Joseph B., additional, and Neubauer, Stefan, additional

Published
2017
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33. ORAL AB AGORA1362Cardiac Involvement in Patients With Different Rheumatic Disorders1366Gender differences in the development of cardiac complications: a multicentric prospective study in a large cohort of thalassemia major patients1646Comparison of T1-mapping, T2-weighted and contrast-enhanced cine imaging at 3.0T CMR for diagnostic oedema assessment in ST-segment elevation myocardial infarction1375Evaluation of Tissue Changes in Remote Noninfarcted Myocardium after Acute Myocardial Infarction using T1-mapping1377Right ventricular long axis strain – The prognostic value of a novel parameter in non-ischemic dilated cardiomyopathy using standard cardiac magnetic resonance imaging1389The role of the right ventricular insertion point in heart failure patients with preserved ejection fraction: Insights from a cardiovascular magnetic resonance study1398Myocardial fibrosis associates with B-type natriuretic peptide levels and outcomes more than wall stress1478Prognostic Value of Pulmonary Blood Volume by Contrast-Enhanced Magnetic Resonance Imaging in Heart Failure Outpatients – The PROVE-HF Study1370Magnetic Resonance Adenosine Perfusion Imaging as Gatekeeper of Invasive Coronary1509Influence of non-invasive hemodynamic CMR parameters on maximal exercise capacity in surgically untreated patients with Ebstein's anomaly1356Proximal aortic stiffening in Turner patients is more pronounced in the presence of a bicuspid valve. A segmental functional MRI study1503Flow pattern and vascular distensibility of the pulmonary arteries in patients after repair of tetralogy of Fallot. Insights from 4D flow CMR1516Myocardial deformation characteristics of the systemic right ventricle after atrial switch operation for transposition of the great arteries1633Three-dimensional vortex formation in patients with a Fontan circulation: evaluation with 4D flow CMR1483Mitral valve prolapse: arrhythmogenic substrates by cardiac magnetic imaging1596Increased local wall shear stress after coarctation repair is associated with descending aorta pulse wave velocity: evaluation with CMR and 4D flow1636Three-dimensional wall shear stress assessed by 4Dflow CMR in bicuspid aortic valve disease1464Cardiac Amyloidosis and Aortic Stenosis – The Convergence of Two Aging Processes1630Blood T1 variability explained in healthy volunteers: an analysis on MOLLI, ShMOLLI and SASHA1408Myocardial deformation on CMR predicts adverse outcomes in carcinoid heart disease - a new marker of risk1492Myocardial Perfusion Reserve and Global Longitudinal Strain in Early Rheumatoid Arthritis1500Exercise CMR to differentiate athlete's heart from patients with early dilated cardiomyopathy1559Real-Time, x-mri guidance to optimise left ventricular lead placement for delivery of cardiac resynchronisation therapy1560The role of Cardiac magnetic resonance imaging in patients undergoing ablation for ventricular tachycardia- Defining the substrate and visualizing the outcome1590Impact of cardiovascular magnetic resonance on clinical management and decision-making of out of hospital cardiac arrest survivors with inconclusive coronary angiogram1561Detection of coronary stenosis at rest using Oxygenation-Sensitive Magnetic Resonance Imaging

Author

Greulich, S., primary, Meloni, A., primary, Nazir, Sheraz A., primary, Stefan Biesbroek, P., primary, Arenja, Nisha, primary, Kammerlander, Andreas A., primary, Sayeed, Aatif, primary, Ricci, F., primary, Bernhardt, Peter, primary, Meierhofer, Christian, primary, Devos, Daniel G.H., primary, Ruecker, Beate, primary, Burkhardt, B.E.U., primary, Kamphuis, Vivian P., primary, De Lazzari, Manuel, primary, Nederend, I., primary, Dux-Santoy, Lydia, primary, Cavalcante, João L., primary, Rosmini, Stefania, primary, Liu, B., primary, Fent, G.J., primary, Claessen, G., primary, Behar, Jonathan, primary, Oebel, S., primary, Baritussio, A., primary, Ranjit Arnold, J., primary, Kitterer, D., additional, Latus, J., additional, Henes, J., additional, Kurmann, R., additional, Gloekler, S., additional, Wahl, A., additional, Buss, S., additional, Katus, H., additional, Bobbo, M., additional, Lombardi, M., additional, Braun, N., additional, Alscher, M.D., additional, Sechtem, U., additional, Mahrholdt, H., additional, Neri, M.G., additional, Preziosi, P., additional, Grassedonio, E., additional, Schicchi, N., additional, Keilberg, P., additional, Pulini, S., additional, Facchini, E., additional, Positano, V., additional, Pepe, A., additional, Shetye, Abhishek, additional, Khan, Jamal N., additional, Singh, Anvesha, additional, Kanagala, Prathap, additional, Swarbrick, Daniel, additional, Gulsin, Gaurav, additional, Graham-Brown, Matthew, additional, Squire, Iain, additional, Gershlick, Anthony, additional, McCann, Gerry P., additional, Amier, Raquel P., additional, Teunissen, Paul F.A., additional, Robbers, Lourens F.H.J., additional, Beek, Aernout M., additional, van Rossum, Albert C., additional, Hofman, Mark B.M., additional, van Royen, Niels, additional, Nijveldt, Robin, additional, Riffel, Johannes H, additional, Djiokou, Charly Noel, additional, Andre, Florian, additional, Fritz, Thomas, additional, Halder, Manuel, additional, Thomas, Zelniker, additional, Korosoglou, Grigorios, additional, Katus, Hugo A, additional, Buss, Sebastian J, additional, Schwaiger, Marianne L., additional, Duca, Franz, additional, Aschauer, Stefan, additional, Marzluf, Beatrice A., additional, Zotter-Tufaro, Caroline, additional, Dalos, Daniel, additional, Pfaffenberger, Stefan, additional, Bonderman, Diana, additional, Mascherbauer, Julia, additional, Fridman, Yaron, additional, Hackman, Brianne, additional, Kadakkal, Ajay, additional, Maanja, Maren, additional, Daya, Hussein Abu, additional, Wong, Timothy C., additional, Schelbert, Erik B., additional, Barison, A., additional, Todiere, G., additional, Gaeta, R., additional, Galllina, S., additional, Emdin, M., additional, De Caterina, R., additional, Aquaro, G.D., additional, Buckert, Dominik, additional, Dyckmanns, Nils, additional, Rottbauer, Wolfgang, additional, Kühn, Andreas, additional, Shehu, Nerejda, additional, Müller, Jan, additional, Stern, Heiko, additional, Ewert, Peter, additional, Fratz, Sohrab, additional, Vogt, Manfred, additional, De Groote, Katya, additional, Babin, Danilo, additional, Demulier, Laurent, additional, Taeymans, Yves, additional, Westenberg, Jos J., additional, Van Bortel, Luc, additional, Segers, Patrick, additional, Achten, Eric, additional, De Schepper, Jean, additional, Rietzschel, Ernst, additional, Geiger, Julia, additional, Makki, Malek, additional, Burkhardt, Barbara, additional, Kellenberger, Christian J., additional, Buechel, Emanuela R. Valsangiacomo, additional, Kellenberger, C.J., additional, Geiger, J., additional, Ruecker, B., additional, Buechel, E.R. Valsangiacomo, additional, Elbaz, Mohammed S.M., additional, Kroft, Lucia J.M., additional, van der Geest, Rob J., additional, de Roos, Albert, additional, Blom, Nico A., additional, Westenberg, Jos J.M., additional, Roest, Arno A.W., additional, Cipriani, Alberto, additional, Susana, Angela, additional, Rizzo, Stefania, additional, Giorgi, Benedetta, additional, Carmelo, Lacognata, additional, Bertaglia, Emanuele, additional, Bauce, Barbara, additional, Corrado, Domenico, additional, Thiene, Gaetano, additional, Marra, Martina Perazzolo, additional, Basso, Cristina, additional, Iliceto, Sabino, additional, Roest, A.A.W., additional, van den Boogaard, P.J., additional, ten Harkel, A.D.J., additional, de Geus, J.C.N., additional, Kroft, L.J.M., additional, de Roos, A., additional, Westenberg, J.J.M., additional, Kale, Raquel, additional, Teixido-Tura, Gisela, additional, Maldonado, Giuliana, additional, Huguet, Marina, additional, Garcia-Dorado, David, additional, Evangelista, Artur, additional, Rodriguez-Palomares, Jose, additional, Rijal, Shasank, additional, Schindler, John T., additional, Gleason, Thomas G., additional, Lee, Joon S., additional, Bulluck, Heerajnarain, additional, Treibel, Thomas A, additional, Bhuva, Anish, additional, Abdel-Gadir, Amna, additional, Culotta, Veronica, additional, Merghani, Ahmed, additional, Maestrini, Viviana, additional, Herrey, Anna S, additional, Kellman, Peter, additional, Manisty, Charlotte, additional, Moon, James C, additional, Hayer, M.K., additional, Baig, S., additional, Shah, T., additional, Rooney, S.J., additional, Edwards, N.C., additional, Steeds, R.P., additional, Garg, P., additional, Swoboda, P., additional, Dobson, L.E., additional, Musa, T.A., additional, Foley, J.F., additional, Haaf, P., additional, Greenwood, J.P., additional, Plein, S., additional, Schnell, F., additional, Bogaert, J., additional, Dymarkowski, S., additional, Pattyn, N., additional, Claus, P., additional, Van Cleemput, J., additional, Gerche, A. La, additional, Heidbuchel, H., additional, Toth, Daniel, additional, Reiml, Sabrina, additional, Panayiotou, Maria, additional, Claridge, Simon, additional, Jackson, Tom, additional, Sohal, Manav, additional, Webb, Jessica, additional, O'Neill, Mark, additional, Brost, Alexander, additional, Mountney, Peter, additional, Razavi, Reza, additional, Rhode, Kawal, additional, Rinaldi, Christopher Aldo, additional, Arya, A., additional, Hilbert, S., additional, Bollmann, A., additional, Hindricks, G., additional, Jahnke, C., additional, Paetsch, I., additional, Dinov, B., additional, Perazzolo Marra, M., additional, Ghosh Dastidar, A., additional, Rodrigues, J., additional, Zorzi, A., additional, Susana, A., additional, Scatteia, A., additional, De Garate, E., additional, Mattesi, G., additional, Strange, J., additional, Corrado, D., additional, Bucciarelli-Ducci, C., additional, Jerosch-Herold, Michael, additional, Karamitsos, Theodoros D., additional, Francis, Jane M., additional, Bhamra-Ariza, Paul, additional, Sarwar, Rizwan, additional, Choudhury, Robin, additional, Selvanayagam, Joseph B., additional, and Neubauer, Stefan, additional

Published
2016
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37. Integrated genomic approaches implicate osteoglycin (Ogn) in the regulation of left ventricular mass

Author

Petretto, Enrico, primary, Sarwar, Rizwan, additional, Grieve, Ian, additional, Lu, Han, additional, Kumaran, Mande K, additional, Muckett, Phillip J, additional, Mangion, Jonathan, additional, Schroen, Blanche, additional, Benson, Matthew, additional, Punjabi, Prakash P, additional, Prasad, Sanjay K, additional, Pennell, Dudley J, additional, Kiesewetter, Chris, additional, Tasheva, Elena S, additional, Corpuz, Lolita M, additional, Webb, Megan D, additional, Conrad, Gary W, additional, Kurtz, Theodore W, additional, Kren, Vladimir, additional, Fischer, Judith, additional, Hubner, Norbert, additional, Pinto, Yigal M, additional, Pravenec, Michal, additional, Aitman, Timothy J, additional, and Cook, Stuart A, additional

Published
2008
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38. Abstract 751: Integrated Genetic Linkage Analysis and Expression Profiling in the Rat Heart to Identify Primary Drivers of Cardiac Hypertrophy

Author

Sarwar, Rizwan, primary, Petretto, Enrico, additional, Lu, Han, additional, Schroen, Blanche, additional, Kumaran, Mande K, additional, Grieve, Ian C, additional, Fischer, Judith, additional, Hubner, Norbert, additional, Mangion, Jonathan, additional, Pinto, Yigal M, additional, Pravenec, Michal, additional, Aitman, Timothy J, additional, and Cook, Stuart A, additional

Published
2007
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39. Eculizumab treatment for paroxysmal nocturnal haemoglobinuria in a patient with recurrent simultaneous multivessel coronary stent thrombosis.

Author

De Maria, Giovanni Luigi, Sarwar, Rizwan, and Banning, Adrian P.

Subjects
*PLATELET aggregation inhibitors, *HEMOGLOBINURIA, *BLOOD coagulation, *THERAPEUTICS
Abstract

We describe a case of recurrent multivessel coronary stent thrombosis in the absence of the typical hallmarks of this phenomenon: (i) discontinuation or poor compliance with double anti-platelet therapy; (ii) stent malapposition and (iii) stent underexpansion. In this case, the recurrence of stent thrombosis was indeed manifestation of a more complex underlying disease, and eventually allowed the clinicians to come to the final diagnosis of paroxysmal nocturnal haemoglobinuria. [ABSTRACT FROM AUTHOR]

Published
2015
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40. Ventricular Changes in Patients with Acute COVID-19 Infection: Follow-Up of The World Alliance Societies of Echocardiography (WASE-COVID) Study

Author

Karagodin, Ilya, Carvalho Singulane, Cristiane, Descamps, Tine, Woodward, Gary M., Xie, Mingxing, Tucay, Edwin S., Sarwar, Rizwan, Vasquez-Ortiz, Zuilma Y., Alizadehasl, Azin, Monaghan, Mark J., Ordonez Salazar, Bayardo A., Soulat-Dufour, Laurie, Mostafavi, Atoosa, Moreo, Antonella, Citro, Rodolfo, Narang, Akhil, Wu, Chun, Addetia, Karima, Tude Rodrigues, Ana C., Lang, Roberto M., and Asch, Federico M.

Abstract

COVID-19 infection is known to cause a wide array of clinical chronic sequelae but little is known regarding the long-term cardiac complications. We aim to report echocardiographic follow-up findings and describe the changes in left and right ventricular function that occur following acute infection.

Published
2021
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41. Safety and Efficacy of Metabolic Modulation With Ninerafaxstat in Patients With Nonobstructive Hypertrophic Cardiomyopathy.

Author

Maron, Martin S., Mahmod, Masliza, Abd Samat, Azlan Helmy, Choudhury, Lubna, Massera, Daniele, Phelan, Dermot M.J., Cresci, Sharon, Martinez, Matthew W., Masri, Ahmad, Abraham, Theodore P., Adler, Eric, Wever-Pinzon, Omar, Nagueh, Sherif F., Lewis, Gregory D., Chamberlin, Paul, Patel, Jai, Yavari, Arash, Dehbi, Hakim-Moulay, Sarwar, Rizwan, and Raman, Betty

Subjects
*HYPERTROPHIC cardiomyopathy, *VENTRICULAR ejection fraction, *OXYGEN consumption, *TREATMENT effectiveness, *DRUG therapy, *CARBON dioxide
Abstract

In nonobstructive hypertrophic cardiomyopathy (nHCM), there are no approved medical therapies. Impaired myocardial energetics is a potential cause of symptoms and exercise limitation. Ninerafaxstat, a novel cardiac mitotrope, enhances cardiac energetics. This study sought to evaluate the safety and efficacy of ninerafaxstat in nHCM. Patients with hypertrophic cardiomyopathy and left ventricular outflow tract gradient <30 mm Hg, ejection fraction ≥50%, and peak oxygen consumption <80% predicted were randomized to ninerafaxstat 200 mg twice daily or placebo (1:1) for 12 weeks. The primary endpoint was safety and tolerability, with efficacy outcomes also assessed as secondary endpoints. A total of 67 patients with nHCM were enrolled at 12 centers (57 ± 11.8 years of age; 55% women). Serious adverse events occurred in 11.8% (n = 4 of 34) in the ninerafaxstat group and 6.1% (n = 2 of 33) of patients in the placebo group. From baseline to 12 weeks, ninerafaxstat was associated with significantly better V E /V co 2 (ventilatory efficiency) slope compared with placebo with a least-squares (LS) mean difference between the groups of −2.1 (95% CI: −3.6 to −0.6; P = 0.006), with no significant difference in peak VO 2 (P = 0.90). The Kansas City Cardiomyopathy Questionnaire Clinical Summary Score was directionally, though not significantly, improved with ninerafaxstat vs placebo (LS mean 3.2; 95% CI: −2.9 to 9.2; P = 0.30); however, it was statistically significant when analyzed post hoc in the 35 patients with baseline Kansas City Cardiomyopathy Questionnaire Clinical Summary Score ≤80 (LS mean 9.4; 95% CI: 0.3-18.5; P = 0.04). In symptomatic nHCM, novel drug therapy targeting myocardial energetics was safe and well tolerated and associated with better exercise performance and health status among those most symptomatically limited. The findings support assessing ninerafaxstat in a phase 3 study. [Display omitted] [ABSTRACT FROM AUTHOR]

Published
2024
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42. Abstracts

Author

Treibel, Thomas A., Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Sayeed, Aatif, Maanja, Maren, Daya, Hussein Abu, Moon, James C., Wong, Timothy C., Schelbert, Erik B., Duca, Franz, Kammerlander, Andreas A., Zotter-Tufaro, Caroline, Aschauer, Stefan, Bonderman, Diana, Mascherbauer, Julia, Schwitter, Juerg, Beigelman-Aubry, Catherine, Peguret, Nicolas, Stuber, Matthias, Delacoste, Jean, Belmondo, Bastien, Lovis, Alban, Simons, Julien, Long, Olivier, Grant, Kathleen, Berchier, Gregoire, Rohner, Chantal, Bonanno, Gabriele, Coppo, Simone, Ozsahin, Esat-Mahmut, Qanadli, Salah, Meuli, Reto, Bourhis, Jean, Ide, Seiko, Riesenkampff, Eugenie, Chiasson, David, Dipchand, Anne I., Kantor, Paul F., Chaturvedi, Rajiv R., Yoo, Shi-Joon, Grosse-Wortmann, Lars, Sandrini, C., Aquaro, GD, De Marchi, D, Ait Ali, L, Khraiche, D, Boddaert, N, Bonnet, D, Raimondi, F, Fridman, Yaron, Hackman, Brianne E., Kadakkal, Ajay, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Angela, Susana, Alberto, Cipriani, Manuel, De Lazzari, Federico, Marin, Francesca, Prevedello, Bendetta, Giorgi, Giorgio, De Conti, Giuseppe, Tarantini, Luisa, Cacciavillani, Emanuele, Bertaglia, Domenico, Corrado, Sabino, Iliceto, Martina, Perazzolo Marra, Camaioni, Claudia, Morlon, Lucas, Vergé, Marie-Philippe, Jais, Pierre, Roudaut, Raymond, Laurent, Francois, Lafitte, Stéphane, Cochet, Hubert, Réant, Patricia, Bohnen, S., Radunski, U. K., Lund, G. K., Senel, M., Avanesov, M., Tahir, E., Stehning, C., Adam, G., Blankenberg, S., Muellerleile, K., Khanji, Mohammed Y., Balawon, Armida, Boubertakh, Redha, Petersen, Steffen E, Hilbert, Sebastian, Spampinato, Ricardo, Oebel, Sabrina, Hindricks, Gerhard, Bollmann, Andreas, Jahnke, Cosima, Paetsch, Ingo, Goetschalckx, K., Bogaert, J., Desmet, W., Toth, A., Merkely, B., Janssens, S., Claus, P., Calvieri, C., Preda, M. B., Perfetti, A., Valaperta, R., Secchi, F., Fedele, F., Martelli, F., Lombardi, M., Reinstadler, Sebastian J., Eitel, Charlotte, Fuernau, Georg, de Waha, Suzanne, Desch, Steffen, Mende, Meinhard, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Maestrini, Viviana, Mun, Hong Cheang, Kotwinski, Paul, Rosmini, Stefania, Sanders, Julie, Lloyd, Guy, Dudley, J. Pennell, Kellman, Peter, Hugh, E. Montgomery, Manisty, Charlotte, James, C. Moon, James, S., Waterhouse, D.F., Murphy, T.M., Kenny, C., O'Hanlon, R., Bastiaenen, Rachel, Cox, Andrew T., Wijeyeratne, Yanushi, Colbeck, Nicholas, Pakroo, Nadia, Ahmed, Hammad, Bunce, Nick, Anderson, Lisa, Prasad, Sanjay, Sharma, Sanjay, Behr, Elijah R., Reid, A. B., Miller, C., Jovanovic, A., Woolfson, P., Abidin, N., Schmitt, M., Amadu, A.M., Rodrigues, J.C.L., Dastidar, A. Ghosh, Baritussio, A., Lawton, C., Venuti, G., Meloni, G.B., Conti, M., Bucciarelli-Ducci, C., Pontone, Gianluca, Andreini, Daniele, SoLbiati, Anna, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Rota, Cristina, Guaricci, Andrea I., Pepi, Mauro, Wang, Yufei, Joannic, David, Juillion, Patrick, Delassus, P., Monnet, Aurélien, Lalande, Alain, Fontaine, Jean-Francois, Zweerink, A, Allaart, CP, Wu, L, Kuijer, JPA, Beek, AM, Croisille, P, Clarysse, P, van Rossum, AC, Nijveldt, R, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Hammond-Haley, Matthew, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Garg, P., Hassell, M, Foley, J., Ripley, D.P., Dobson, L., Swoboda, P.P., Fent, G., Musa, T.A., Erhayiem, B., Haaf, P., Greenwood, J.P., Nijveldt, R., Westenberg, J.J.M., Geest, R.J.V.D., Plein, S., Rodrigues, Jonathan C L, Amadu, Antonio Matteo, Dastidar, Amardeep Ghosh, Szantho, Gergley, Lyen, Stephen, Godsave, Cattleya, Ratcliffe, Laura E K, Burchell, Amy E, Hart, Emma C, Hamilton, Mark C K, Nightingale, Angus K, Paton, Julian F R, Manghat, Nathan E, Bucciarelli-Ducci, Chiara, Hafyane, Tarik, Teixeira, Tiago, Greiser, Andreas, Mongeon, Francois Pierre, Haifa, Almutairi, Mohammed, Khanji, Redha, Boubertakh, Marc, Miquel, Steffen, Petersen, Greulich, S., Kitterer, D., Latus, J., Henes, J., Kurmann, R., Gloekler, S., Wahl, A., Buss, S., Katus, H., Bobbo, M., Lombardi, M., Braun, N., Alscher, M.D., Sechtem, U., Mahrholdt, H., Meloni, A., Neri, M.G., Preziosi, P., Grassedonio, E., Schicchi, N., Keilberg, P., Pulini, S., Facchini, E., Positano, V., Pepe, A., Nazir, Sheraz A., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Squire, Iain, Gershlick, Anthony, McCann, Gerry P., Stefan Biesbroek, P., Amier, Raquel P., Teunissen, Paul F.A., Robbers, Lourens F.H.J., Beek, Aernout M., van Rossum, Albert C., Hofman, Mark B.M., van Royen, Niels, Nijveldt, Robin, Arenja, Nisha, Riffel, Johannes H, Djiokou, Charly Noel, Andre, Florian, Fritz, Thomas, Halder, Manuel, Thomas, Zelniker, Korosoglou, Grigorios, Katus, Hugo A, Buss, Sebastian J, Kammerlander, Andreas A., Schwaiger, Marianne L., Duca, Franz, Aschauer, Stefan, Marzluf, Beatrice A., Zotter-Tufaro, Caroline, Dalos, Daniel, Pfaffenberger, Stefan, Bonderman, Diana, Mascherbauer, Julia, Sayeed, Aatif, Fridman, Yaron, Hackman, Brianne, Kadakkal, Ajay, Maanja, Maren, Daya, Hussein Abu, Wong, Timothy C., Schelbert, Erik B., Ricci, F., Barison, A., Todiere, G., Gaeta, R., Galllina, S., Emdin, M., De Caterina, R., Aquaro, G.D., Bernhardt, Peter, Buckert, Dominik, Dyckmanns, Nils, Rottbauer, Wolfgang, Meierhofer, Christian, Kühn, Andreas, Shehu, Nerejda, Müller, Jan, Stern, Heiko, Ewert, Peter, Fratz, Sohrab, Vogt, Manfred, Devos, Daniel G.H., De Groote, Katya, Babin, Danilo, Demulier, Laurent, Taeymans, Yves, Westenberg, Jos J., Van Bortel, Luc, Segers, Patrick, Achten, Eric, De Schepper, Jean, Rietzschel, Ernst, Ruecker, Beate, Geiger, Julia, Makki, Malek, Burkhardt, Barbara, Kellenberger, Christian J., Buechel, Emanuela R. Valsangiacomo, Burkhardt, B.E.U., Kellenberger, C.J., Geiger, J., Ruecker, B., Buechel, E.R. Valsangiacomo, Kamphuis, Vivian P., Elbaz, Mohammed S.M., Kroft, Lucia J.M., van der Geest, Rob J., de Roos, Albert, Blom, Nico A., Westenberg, Jos J.M., Roest, Arno A.W., De Lazzari, Manuel, Cipriani, Alberto, Susana, Angela, Rizzo, Stefania, Giorgi, Benedetta, Carmelo, Lacognata, Bertaglia, Emanuele, Bauce, Barbara, Corrado, Domenico, Thiene, Gaetano, Marra, Martina Perazzolo, Basso, Cristina, Iliceto, Sabino, Nederend, I., Roest, A.A.W., van den Boogaard, P.J., ten Harkel, A.D.J., de Geus, J.C.N., Kroft, L.J.M., de Roos, A., Westenberg, J.J.M., Dux-Santoy, Lydia, Kale, Raquel, Teixido-Tura, Gisela, Maldonado, Giuliana, Huguet, Marina, Garcia-Dorado, David, Evangelista, Artur, Rodriguez-Palomares, Jose, Cavalcante, João L., Rijal, Shasank, Schindler, John T., Gleason, Thomas G., Lee, Joon S., Schelbert, Erik B., Rosmini, Stefania, Bulluck, Heerajnarain, Treibel, Thomas A, Bhuva, Anish, Abdel-Gadir, Amna, Culotta, Veronica, Merghani, Ahmed, Maestrini, Viviana, Herrey, Anna S, Kellman, Peter, Manisty, Charlotte, Moon, James C, Liu, B., Hayer, M.K., Baig, S., Shah, T., Rooney, S.J., Edwards, N.C., Steeds, R.P., Fent, G.J., Garg, P., Swoboda, P., Dobson, L.E., Musa, T.A., Foley, J.F., Haaf, P., Greenwood, J.P., Plein, S., Claessen, G., Schnell, F., Bogaert, J., Dymarkowski, S., Pattyn, N., Claus, P., Van Cleemput, J., Gerche, A. La, Heidbuchel, H., Behar, Jonathan, Toth, Daniel, Reiml, Sabrina, Panayiotou, Maria, Claridge, Simon, Jackson, Tom, Sohal, Manav, Webb, Jessica, O'Neill, Mark, Brost, Alexander, Mountney, Peter, Razavi, Reza, Rhode, Kawal, Rinaldi, Christopher Aldo, Oebel, S., Arya, A., Hilbert, S., Bollmann, A., Hindricks, G., Jahnke, C., Paetsch, I., Dinov, B., Baritussio, A., Perazzolo Marra, M., Ghosh Dastidar, A., Rodrigues, J., Zorzi, A., Susana, A., Scatteia, A., De Garate, E., Mattesi, G., Strange, J., Corrado, D., Bucciarelli-Ducci, C., Ranjit Arnold, J., Jerosch-Herold, Michael, Karamitsos, Theodoros D., Francis, Jane M., Bhamra-Ariza, Paul, Sarwar, Rizwan, Choudhury, Robin, Selvanayagam, Joseph B., Neubauer, Stefan, Tayal, Upasana, Scott, Andrew D, Wage, Rick, Ferreira, Pedro, Pennell, Dudley, Zhong, Xiaodong, Epstein, Fred, Firmin, David, Prasad, Sanjay, Kallifatidis, Alexandros, Prousalis, Anastasios, Mouratoglou, Sophia-Anastasia, Giannakoulas, George, Deligianni, Xenia, Bakaloudis, Michail, Magganaris, Nikolaos, Sianos, George, Karvounis, Haralampos, Santini, Francesco, Garg, P., Aziz, R., Foley, J.R.J., Fent, G., Musa, T.A., Haaf, P., Dobson, L., Swoboda, P.P., Greenwood, J.P., Plein, S., Geest, R.J.V.D., Westenberg, J.J.M., Beitzke, D., Rasul, S., Wadsak, W., Mitterhauser, M., Nolz, R., Stelzmueller, M., Loewe, C., Hacker, M., Funk, Stephanie, Kermer, Josephine, Dogangüzel, Serkan, von Knobelsdorff-Brenkenhoff, Florian, Schulz-Menger, Jeanette, Kolker, Shimon, Weisz, Giora, Bogot, Naama, Halpern, Irit Hadas, Wolak, Arik, Rutz, Tobias, Ginami, Giulia, Piccini, Davide, Coppo, Simone, Vincenti, Gabriella, Stuber, Matthias, Schwitter, Jürg, Safdar, Komal S, Gao, Xuexin, Ambach, Stephanie, Taylor, Michal D, Moore, Ryan, Taylor, Robin J, Toro-Salazar, Olga, Jeffries, John L, Bartone, Cheryl, Raman, Subha V, Mazur, Wojciech, Valente, F., Rodriguez-Palomares, J.F., Gutierrez, L., Pineda, V., Agliano, B., Galian, L., Teixido, G., Gonzalez-Alujas, M.T., Evangelista, A., Garcia-Dorado, D., Murdoch, R., Gandy, S., Nicholas, R., Houston, G., Martin, P., Muir, J., Matthew, S., Ramkumar, P. Guntur-, Cavin, I., Macaione, F., Barison, A., Pescetelli, I., Pali, F., Pizzino, F., Terrizzi, A., Di Lisi, D., Novo, G., Todiere, G., Assennato, P., Novo, S., Aquaro, G.D., Dastidar, Amardeep Ghosh, McAlindon, Elisa, Rodrigues, Jonathan, Baritussio, Anna, Scatteia, Alessandra, De Garate, Estefania, Benny Lawton, Chris, Erdei, Tamas, Szantho, Gergely, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Pontone, Gianluca, Andreini, Daniele, Rota, Cristina, Guglielmo, Marco, Mushtaq, Saima, Baggiano, Andrea, Beltrama, Virginia, Solbiati, Anna, Guaricci, Andrea I., Pepi, Mauro, Grigoratos, Chrysanthos, Bratis, Konstantinos, Henningson, Markus, Dell'Omodarme, Matteo, Puntmann, Valentina O., Nagel, Eike, Meloni, Antonella, Giunta, Nicola, Giuliano, Pietro, Neri, Maria Giovanna, Restaino, Gennaro, Renne, Stefania, Quota, Alessandra, Positano, Vincenzo, De Marchi, Daniele, Pepe, Alessia, Pedrotti, Patrizia, Campadello, Paola, Masciocco, Gabriella, Facchetti, Rita, Milazzo, Angela, Quattrocchi, Giuseppina, Giannattasio, Cristina, Frigerio, Maria, Roghi, Alberto, Rimoldi, Ornella, De Garate, Estefania, Ghosh Dastidar, Amardeep, Baritussio, Anna, Scatteia, Alessandra, Amadu, Antonio, Venuti, Giuseppe, Rodrigues, Jonathan C., Bucciarelli-Ducci, Chiara, Careri, Giulia, Castelvecchio, Serenella, Camporeale, Antonia, Secchi, Francesco, Menicanti, Lorenzo, Lombardi, Massimo, Kockova, R., Sedlacek, K., Wichterle, D., Sikula, V., Tintera, J., Sukupova, L., Kautznerova, D., Segetova, M., Praveckova, A., Langova, R., Kryze, L., El-Husseini, W., Kautzner, J., Oebel, S., Dinov, B., Arya, A., Hilbert, S., Sommer, P., Bollmann, A., Hindricks, G., Paetsch, I., Jahnke, C., Nazir, Sheraz A., Greenwood, John P., Shetye, Abhishek, Khan, Jamal N., Singh, Anvesha, Kanagala, Prathap, Swarbrick, Daniel, Gulsin, Gaurav, Graham-Brown, Matthew, Gershlick, Anthony, McCann, Gerry P., Grigoratos, Chrysanthos, Liga, Riccardo, Bennatti, Elena, Barison, Andrea, Todiere, Giancarlo, Aquaro, Giovanni Donato, Dell'Omodarme, Matteo, Lombardi, Massimo, Emdin, Michele, Masci, Pier Giorgio, Barison, A, Ortalda, A, Todiere, G, Grigoratos, C, Vergaro, G, Mirizzi, G, Martini, N, De Marchi, D, Keilberg, P, Passino, C, Aquaro, GD, Emdin, M, Swoboda, Peter P, McDiarmid, Adam K, Erhayiem, Bara, Fent, Graham J, Dobson, Laura E, Garg, Pankaj, Musa, Tarique A, Foley, James R, Page, Stephen P, Greenwood, John P, Plein, Sven, Bulluck, Heerajnarain, Rosmini, Stefania, Abdel-Gadir, Amna, Bhuva, Anish, Treibel, Thomas A, White, Steven K, Fontana, Marianna, Ramlall, Manish, Hamarneh, Ashraf, Sirker, Alex, Herrey, Anna, Manisty, Charlotte, Yellon, Derek M, Kellman, Peter, Moon, James C, Hausenloy, Derek J, Broncano, J., Luna, A., Noguerol, T. Martin –, Caro, P., Toro-Cebada, R., Gonzalez, J. Sanchez –, Desroche, L.M., Milleron, O., Safar, B., Lavie-Badie, Y., Millischer, D., Abtan, J., Jondeau, G., Bermejo, Zorba Blázquez, Cuesta, Emilio, Rosillo, Sandra O., Guzmán, Gabriela, Pinilla, Inmaculada, González, Óscar, Caro, Juan, Ponz, Inés, López, Teresa, Refoyo, Elena, Kozor, Rebecca, Nordin, Sabrina, Treibel, Thomas A, Rosmini, Stefania, Castelleti, Silvia, Fontana, Marianna, Captur, Gabriella, Steeds, Rick, Baig, Shanat, Manisty, Charlotte, Grieve, Stuart M, Figtree, Gemma A, Moon, James C, Dastidar, Amardeep Ghosh, Rodrigues, Jonathan, De Garate, Estefania, Singhal, Priyanka, McAlindon, Elisa, Baritussio, Anna, Scatteia, Alessandra, Erdei, Tamas, Strange, Julian, Nightingale, Angus, Baumbach, Andreas, Johnson, Tom, Delgado, Victoria, Bucciarelli-Ducci, Chiara, Lapinskas, Tomas, Bucius, Paulius, Fedaravicius, Augustinas P., Urbonaite, Laura, Stabinskaite, Agnieta, Zaliunas, Remigijus, Elisabetta, Chiodi, Teresa, Cannizzaro Maria, Daniele, De Falco Alfano, Righi, Riccardo, Zerbini, Michela, Vincenzo, Positano, Cittanti, Corrado, Giganti, Melchiore, Giorgio, Benea, Grigoratos, Chrysanthos, Genovesi, Dario, Giorgetti, Assuero, Chiappino, Sara, Barison, Andrea, Vergaro, Giuseppe, Todiere, Giancarlo, Emdin, Michele, Marzullo, Paolo, Aquaro, Giovanni Donato, Ladeiras-Lopes, Ricardo, Turin-Moreira, Henrique, Bettencourt, Nuno, Fontes-Carvalho, Ricardo, Sampaio, Francisco, Ambale-Venkatesh, Bharath, Wu, Colin, Liu, Kiang, Bertoni, Alain, Ouyang, Pamela, Bluemke, David, Lima, João, Fent, GJ., Garg, P., Dobson, LE., Musa, TA., Foley, JF., Haaf, P., Greenwood, JP., Plein, S., Swoboda, PP., Abdul Rahman, E., Ismail, JR., Najme Khir, R., Lim, CW., Chua, N., Ibrahim, ZO., Zainal Abidin, HA., Mohd Arshad, MK., Kasim, SS., Rodrigues, Jonathan, Rooms, Ben, Hyde, Katie, Rohan, Stephen, Dastidar, Amardeep Ghosh, Hamilton, Mark, Bucciarelli-Ducci, Chiara, Nightingale, Angus, Paton, Julian, Manghat, Nathan, MacIver, David, Gibelli, Giuseppe, Demolli, Walter, Russo, Alessandra, Minoia, Chiara, Biasi, Salvatore, Mkrtchyan, Naira, Eltschkner, Christin, Christian, Meierhofer, Ewert, Peter, Martinoff, Stefan, Stern, Heiko, Fratz, Sohrab, Valinoti, Maddalena, Fabbri, Claudio, Mantovan, Roberto, Severi, Stefano, Corsi, Cristiana, Nyktari, E., Vassiliou, V., Arzanauskaite, M., Izgi, C., Lam, W., Prasad, S., Reindl, Martin, Reinstadler, Sebastian Johannes, Feistritzer, Hans-Josef, Klug, Gert, Mair, Johannes, Mayr, Agnes, Jaschke, Werner, Franz, Wolfgang-Michael, Metzler, Bernhard, Arnhold, K., Muehlberg, F., Fritschi, S., Funk, S., Prothmann, M., von Knobelsdorff-Brenkenhoff, F., Schulz-Menger, J., Lakhani, Zeeshan S. A., Mohan, B., karthik, G A., Raj, Vimal, Weir-McCall, Jonathan, Cassidy, Deirdre B, Belch, Jill JF, Gandy, Stephen J, Houston, Graeme, Lambert, Matthew A, Littleford, Roberta, Rowland, Janice, Struthers, Allan D, Khan, Faisel, Camaioni, Claudia, Salel, Marjorie, Hennig, Alexia, Corneloup, Olivier, Montaudon, Michel, Laurent, Francois, Cochet, Hubert, Kan, Rachel, Erhayiem, Bara, McDiarmid, Adam K., Garg, Pankaj, Dobson, Laura E., Musa, Tarique A., Ripley, David, Ajjan, Ramzi, Greenwood, John P., Plein, Sven, Swoboda, Peter P., Reinstadler, Sebastian J., Fuernau, Georg, Eitel, Charlotte, de Waha, Suzanne, Desch, Steffen, Metzler, Bernhard, Schuler, Gerhard, Thiele, Holger, Eitel, Ingo, Feistritzer, Hans-Josef, Reinstadler, Sebastian Johannes, Klug, Gert, Reindl, Martin, Mair, Johannes, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Feistritzer, Hans-Josef, Klug, Gert, Reinstadler, Sebastian Johannes, Reindl, Martin, Mayr, Agnes, Franz, Wolfgang-Michael, Metzler, Bernhard, Festa, P., Cadoni, A., D'andrea, C., Costa, S., Keilberg, P., Lunardini, A., Ali, L. 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Abstract

Objectives: Myocardial fibrosis in noninfarcted myocardium is emerging as a principal phenotype of vulnerability to adverse events such as mortality and hospitalization for heart failure (HHF), but its optimal noninvasive measurement remains uncertain despite consistently robust histologic validation data for extracellular volume fraction (ECV). We therefore compared ECV, native T1, post contrast T1, the gadolinium contrast partition coefficient (lambda), and the presence of nonischemic scar in their associations with mortality and HHF outcomes. Method: To quantify of myocardial fibrosis, we performed T1 mapping (MOLLI) in basal and mid short axis slices with cardiovascular magnetic resonance (CMR) before contrast and 12-30 minutes post contrast bolus in 1185 consecutive patients without amyloidosis, hypertrophic or stress cardiomyopathy. We assessed associations with outcomes using Kaplan-Meier plots and chi square values from univariable Cox regression models. All standard T1 mapping parameters were obtained: native and post contrast myocardial T1, the partition coefficient lambda, and ECV. ECV = (1-hematocrit) · [ΔR1myocardium]/[ΔR1bloodpool], where R1 = 1/T1 Late gadolinium enhancement imaging with phase sensitive reconstruction identified nonischemic scar. Results: Over a median of 1.7 years, 111 individuals experienced events after CMR: 55 HHF events and 74 deaths. ECV yielded better separation of Kaplan-Meier curves in a dose dependent fashion (Figure) and also stronger associations with the combined endpoint of death or HHF. The ECV chi square (77.3, p < 0.001) was at least twice as large as the Native T1 chi square (37.5, p < 0.001), the lambda chi square (34.8, p < 0.001) and nonischemic scar (chi square = 20.5, p<0.001). Post-contrast T1 was not associated with outcomes, even when adjusting further for time after contrast bolus, renal function, and patient weight (chi square <3, p >0.10). Conclusion: Analogous to histologic previously published validation data, quantitative ECV myocardial fibrosis measures associated with outcomes far stronger than other surrogate measures outcome measures such as native T1, post contrast T1 and nonischemic scar on LGE images. These data suggest that ECV is the noninvasive metric of choice to measure myocardial fibrosis. Figure. Kaplan-Meier Plots for T1 mapping parameters.

Published
2016
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43. Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study.

Author

Woodward W, Johnson CL, Krasner S, O'Driscoll J, McCourt A, Dockerill C, Balkhausen K, Chandrasekaran B, Firoozan S, Kardos A, Sabharwal N, Sarwar R, Senior R, Sharma R, Wong K, Augustine DX, and Leeson P

Subjects
Humans, Female, Male, United Kingdom, Follow-Up Studies, Middle Aged, Prospective Studies, Aged, Time Factors, Chest Pain diagnostic imaging, Risk Assessment, Myocardial Infarction diagnostic imaging, Echocardiography, Stress
Abstract

Aims: Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result to inform on likely longer-term outcomes when applied in real-world practice across a healthcare system has not been previously reported., Methods and Results: Five thousand five hundred and three patients recruited across 32 UK NHS hospitals between 2018 and 2022, participating in the EVAREST/BSE-NSTEP prospective cohort study, with data on medical outcomes up to 2023 available from NHS England were included in the analysis. Stress echocardiography results were related to outcomes, including death, procedures, hospital admissions, and relevant cardiovascular diagnoses, based on Kaplan-Meier analysis and Cox proportional hazard ratios (HRs). Median follow-up was 829 days (interquartile range 224-1434). A positive stress echocardiogram was associated with a greater risk of myocardial infarction [HR 2.71, 95% confidence interval (CI) 1.73-4.24, P < 0.001] and a composite endpoint of cardiac-related mortality and myocardial infarction (HR 2.03, 95% CI 1.41-2.93, P < 0.001). Hazard ratios increased with ischaemic burden. A negative stress echocardiogram identified an event-free 'warranty period' of at least 5 years in patients with no prior history of coronary artery disease and 4 years for those with disease., Conclusion: In real-world practice, the degree of myocardial ischaemia recorded by clinicians at stress echocardiography correctly categorizes risk of future events over the next 5 years. Reporting a stress echocardiogram as negative correctly identifies patients with no greater than a background risk of cardiovascular events over a similar time period., Competing Interests: Conflict of interest: A.K. has received an educational grant from Lantheus Medical Imaging and honoraria from Bracco and Tom-Tec-Phillips. K.W. is a member of the British Cardiovascular Society Guidelines and Practice Committee (unpaid role). R.Se. has received honoraria from Bracco, Lantheus Medical Imaging, and GE Healthcare. P.L. is a shareholder and founder of Ultromics Ltd and has received personal consultancy fees from Ultromics Ltd. P.L. is an inventor on patients in the field of echocardiography. All other authors have no conflicts of interest to declare., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2025
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44. Real-world performance and accuracy of stress echocardiography: the EVAREST observational multi-centre study.

Author

Woodward W, Dockerill C, McCourt A, Upton R, O'Driscoll J, Balkhausen K, Chandrasekaran B, Firoozan S, Kardos A, Wong K, Woodward G, Sarwar R, Sabharwal N, Benedetto E, Spagou N, Sharma R, Augustine D, Tsiachristas A, Senior R, Leeson P, Boardman H, d'Arcy J, Abraheem A, Banypersad S, Boos C, Bulugahapitiya S, Butts J, Coles D, Easaw J, Hamdan H, Jamil-Copley S, Kanaganayagam G, Mwambingu T, Pantazis A, Papachristidis A, Rajani R, Rasheed MA, Razvi NA, Rekhraj S, Ripley DP, Rose K, Scheuermann-Freestone M, Schofield R, and Sultan A

Subjects
Aged, Chest Pain, Dobutamine, Exercise Test, Female, Humans, Male, Coronary Artery Disease diagnostic imaging, Echocardiography, Stress
Abstract

Aims: Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography., Methods and Results: Participants undergoing stress echocardiography for CAD were recruited from 31 hospitals. Participants were followed up through health records which underwent expert adjudication. Cardiac outcome was defined as anatomically or functionally significant stenosis on angiography, revascularization, medical management of ischaemia, acute coronary syndrome, or cardiac-related death within 6 months. A total of 5131 patients (55% male) participated with a median age of 65 years (interquartile range 57-74). 72.9% of studies used dobutamine and 68.5% were contrast studies. Inducible ischaemia was present in 19.3% of scans. Sensitivity and specificity for prediction of a cardiac outcome were 95.4% and 96.0%, respectively, with an accuracy of 95.9%. Sub-group analysis revealed high levels of predictive accuracy across a wide range of patient and protocol sub-groups, with the presence of a resting regional wall motion abnormalitiy significantly reducing the performance of both dobutamine (P < 0.01) and exercise (P < 0.05) stress echocardiography. Overall accuracy remained consistently high across all participating hospitals., Conclusion: Stress echocardiography has high accuracy across UK-based hospitals and thus indicates stress echocardiography is being delivered effectively in real-world practice, reinforcing its role as a first-line investigation in the assessment of patients with stable chest pain., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2022
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