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Zagatina A, Rivadeneira Ruiz M, Ciampi Q, Wierzbowska-Drabik K, Kasprzak J, Kalinina E, Begidova I, Peteiro J, Arbucci R, Marconi S, Lowenstein J, Boshchenko A, Manganelli F, Čelutkienė J, Morrone D, Merli E, Re F, Borguezan-Daros C, Haberka M, Saad AK, Djordjevic-Dikic A, Ratanasit NC, Rigo F, Colonna P, Pretto JLDCES, Mori F, D’Alfonso MG, Ostojic M, Stanetic B, Preradovic TK, Costantino F, Barbieri A, Citro R, Pitino A, Pepi M, Carerj S, Pellikka PA, Picano E. Rest and Stress Left Atrial Dysfunction in Patients with Atrial Fibrillation. J Clin Med 2023; 12:5893. [PMID: 37762833 PMCID: PMC10532252 DOI: 10.3390/jcm12185893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Left atrial (LA) myopathy with paroxysmal and permanent atrial fibrillation (AF) is frequent in chronic coronary syndromes (CCS) but sometimes occult at rest and elicited by stress. AIM This study sought to assess LA volume and function at rest and during stress across the spectrum of AF. METHODS In a prospective, multicenter, observational study design, we enrolled 3042 patients [age = 64 ± 12; 63.8% male] with known or suspected CCS: 2749 were in sinus rhythm (SR, Group 1); 191 in SR with a history of paroxysmal AF (Group 2); and 102 were in permanent AF (Group 3). All patients underwent stress echocardiography (SE). We measured left atrial volume index (LAVI) in all patients and LA Strain reservoir phase (LASr) in a subset of 486 patients. RESULTS LAVI increased from Group 1 to 3, both at rest (Group 1 = 27.6 ± 12.2, Group 2 = 31.6 ± 12.9, Group 3 = 43.3 ± 19.7 mL/m2, p < 0.001) and at peak stress (Group 1 = 26.2 ± 12.0, Group 2 = 31.2 ± 12.2, Group 3 = 43.9 ± 19.4 mL/m2, p < 0.001). LASr progressively decreased from Group 1 to 3, both at rest (Group 1 = 26.0 ± 8.5%, Group 2 = 23.2 ± 11.2%, Group 3 = 8.5 ± 6.5%, p < 0.001) and at peak stress (Group 1 = 26.9 ± 10.1, Group 2 = 23.8 ± 11.0 Group 3 = 10.7 ± 8.1%, p < 0.001). Stress B-lines (≥2) were more frequent in AF (Group 1 = 29.7% vs. Group 2 = 35.5% vs. Group 3 = 57.4%, p < 0.001). Inducible ischemia was less frequent in SR (Group 1 = 16.1% vs. Group 2 = 24.7% vs. Group 3 = 24.5%, p = 0.001). CONCLUSIONS In CCS, rest and stress LA dilation and reservoir dysfunction are often present in paroxysmal and, more so, in permanent AF and are associated with more frequent inducible ischemia and pulmonary congestion during stress.
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Affiliation(s)
- Angela Zagatina
- Cardiology Department, Research Scientific Cardiocenter “Medika”, 197110 St. Petersburg, Russia; (A.Z.); (E.K.); (I.B.)
| | | | - Quirino Ciampi
- Fatebenefratelli Hospital of Benevento, 82100 Benevento, Italy;
| | | | - Jaroslaw Kasprzak
- Cardiology Department, Bieganski Hospital, Medical University, 93-510 Lodz, Poland;
| | - Elena Kalinina
- Cardiology Department, Research Scientific Cardiocenter “Medika”, 197110 St. Petersburg, Russia; (A.Z.); (E.K.); (I.B.)
| | - Irina Begidova
- Cardiology Department, Research Scientific Cardiocenter “Medika”, 197110 St. Petersburg, Russia; (A.Z.); (E.K.); (I.B.)
| | - Jesus Peteiro
- CHUAC—Complexo Hospitalario Universitario A Coruna, University of A Coruna, 15071 La Coruna, Spain;
| | - Rosina Arbucci
- Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina; (R.A.); (S.M.); (J.L.)
| | - Sofia Marconi
- Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina; (R.A.); (S.M.); (J.L.)
| | - Jorge Lowenstein
- Cardiodiagnosticos, Investigaciones Medicas Center, Buenos Aires C1082, Argentina; (R.A.); (S.M.); (J.L.)
| | - Alla Boshchenko
- Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, 634028 Tomsk, Russia;
| | - Fiore Manganelli
- Cardiology Department, SG Moscati Hospital, 83100 Avellino, Italy;
| | - Jelena Čelutkienė
- Centre of Cardiology and Angiology, Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Centre of Innovative Medicine, LT-10257 Vilnius, Lithuania;
| | - Doralisa Morrone
- Cardiothoracic Department, University of Pisa, 56126 Pisa, Italy;
| | - Elisa Merli
- Department of Cardiology, Ospedale per gli Infermi, Faenza, 48100 Ravenna, Italy;
| | - Federica Re
- Department of Cardiology, Ospedale San Camillo, 00149 Roma, Italy;
| | | | - Maciej Haberka
- Department of Cardiology, SHS, Medical University of Silesia, 40-635 Katowice, Poland;
| | - Ariel K. Saad
- División de Cardiología, Hospital de Clínicas José de San Martín, Buenos Aires C1120, Argentina;
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, University Center Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia;
| | - Nithima Chaowalit Ratanasit
- Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Fausto Rigo
- Department of Cardiology, Dolo Hospital, 30031 Venice, Italy;
| | - Paolo Colonna
- Cardiology Division, Bari University Hospital, 70100 Bari, Italy;
| | | | - Fabio Mori
- SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, 50139 Firenze, Italy; (F.M.); (M.G.D.)
| | - Maria Grazia D’Alfonso
- SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, 50139 Firenze, Italy; (F.M.); (M.G.D.)
| | - Miodrag Ostojic
- Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina; (M.O.); (B.S.); (T.K.P.)
| | - Bojan Stanetic
- Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina; (M.O.); (B.S.); (T.K.P.)
| | - Tamara Kovacevic Preradovic
- Department of Noninvasive Cardiology, University Clinical Center, School of Medicine, 78000 Banja-Luka, Bosnia and Herzegovina; (M.O.); (B.S.); (T.K.P.)
| | | | - Andrea Barbieri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy;
| | - Rodolfo Citro
- Cardiology Division, Ospedale Ruggi di Aragona, 84100 Salerno, Italy;
| | | | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, 20138 Milano, Italy;
| | - Scipione Carerj
- Cardiology Division, University Hospital Polyclinic G.Martino, University of Messina, 98166 Messina, Italy;
| | | | - Eugenio Picano
- CNR, Institute of Clinical Physiology, 56124 Pisa, Italy;
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Bombardini T, Zagatina A, Ciampi Q, Arbucci R, Merlo PM, Haber DML, Morrone D, D’Andrea A, Djordjevic-Dikic A, Beleslin B, Tesic M, Boskovic N, Giga V, de Castro e Silva Pretto JL, Daros CB, Amor M, Mosto H, Salamè M, Monte I, Citro R, Simova I, Samardjieva M, Wierzbowska-Drabik K, Kasprzak JD, Gaibazzi N, Cortigiani L, Scali MC, Pepi M, Antonini-Canterin F, Torres MAR, Nes MD, Ostojic M, Carpeggiani C, Kovačević-Preradović T, Lowenstein J, Arruda-Olson AM, Pellikka PA, Picano E. Hemodynamic Heterogeneity of Reduced Cardiac Reserve Unmasked by Volumetric Exercise Echocardiography. J Clin Med 2021; 10:jcm10132906. [PMID: 34209955 PMCID: PMC8267648 DOI: 10.3390/jcm10132906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/23/2021] [Accepted: 06/23/2021] [Indexed: 12/04/2022] Open
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.
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Affiliation(s)
- Tonino Bombardini
- Clinical Center of The Republic of Srpska, Faculty of Medicine, University of Banja-Luka, 78000 Banja-Luka, Bosnia and Herzegovina; (T.B.); (M.O.); (T.K.-P.)
| | - Angela Zagatina
- Cardiology Department, Saint Petersburg University Clinic, Saint Petersburg University, 199034 St Petersburg, Russia;
| | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, 82100 Benevento, Italy
- Correspondence:
| | - Rosina Arbucci
- Cardiodiagnosticos, Investigaciones Medicas, C1082 ACB Buenos Aires, Argentina; (R.A.); (P.M.M.); (D.M.L.H.); (J.L.)
| | - Pablo Martin Merlo
- Cardiodiagnosticos, Investigaciones Medicas, C1082 ACB Buenos Aires, Argentina; (R.A.); (P.M.M.); (D.M.L.H.); (J.L.)
| | - Diego M. Lowenstein Haber
- Cardiodiagnosticos, Investigaciones Medicas, C1082 ACB Buenos Aires, Argentina; (R.A.); (P.M.M.); (D.M.L.H.); (J.L.)
| | - Doralisa Morrone
- Cardiothoracic Department, University of Pisa, 56100 Pisa, Italy;
| | - Antonello D’Andrea
- Department of Cardiology-Umberto I° Hospital Nocera Inferiore (Salerno)-L. Vanvitelli University of Campania, 84014 Nocera Inferiore, Italy;
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia; (A.D.-D.); (B.B.); (M.T.); (N.B.); (V.G.)
| | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia; (A.D.-D.); (B.B.); (M.T.); (N.B.); (V.G.)
| | - Milorad Tesic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia; (A.D.-D.); (B.B.); (M.T.); (N.B.); (V.G.)
| | - Nikola Boskovic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia; (A.D.-D.); (B.B.); (M.T.); (N.B.); (V.G.)
| | - Vojislav Giga
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, 11000 Belgrade, Serbia; (A.D.-D.); (B.B.); (M.T.); (N.B.); (V.G.)
| | | | | | - Miguel Amor
- Cardiology Department, Ramos Mejia Hospital, C1221 ADC Buenos Aires, Argentina; (M.A.); (H.M.); (M.S.)
| | - Hugo Mosto
- Cardiology Department, Ramos Mejia Hospital, C1221 ADC Buenos Aires, Argentina; (M.A.); (H.M.); (M.S.)
| | - Michael Salamè
- Cardiology Department, Ramos Mejia Hospital, C1221 ADC Buenos Aires, Argentina; (M.A.); (H.M.); (M.S.)
| | - Ines Monte
- Cardio-Thorax-Vascular Department, Echocardiography Lab, Policlinico Vittorio Emanuele, Catania University, 95124 Catania, Italy;
| | - Rodolfo Citro
- Cardio-Thoracic-Vascular-Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, 84125 Salerno, Italy;
| | - Iana Simova
- Heart and Brain Center of Excellence, University Hospital, 5800 Sofia, Bulgaria; (I.S.); (M.S.)
| | - Martina Samardjieva
- Heart and Brain Center of Excellence, University Hospital, 5800 Sofia, Bulgaria; (I.S.); (M.S.)
| | - Karina Wierzbowska-Drabik
- Department of Cardiology, Bieganski Hospital, Medical University, 93-487 Lodz, Poland; (K.W.-D.); (J.D.K.)
| | - Jaroslaw D. Kasprzak
- Department of Cardiology, Bieganski Hospital, Medical University, 93-487 Lodz, Poland; (K.W.-D.); (J.D.K.)
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, 43100 Parma, Italy;
| | | | | | - Mauro Pepi
- Centro Cardiologico Monzino, IRCCS, 20138 Milano, Italy;
| | - Francesco Antonini-Canterin
- Highly Specialized Rehabilitation Hospital Motta di Livenza, Cardiac Prevention and Rehabilitation Unit, 31045 Treviso, Italy;
| | - Marco A. R. Torres
- Department of Cardiology, Federal University of Rio Grande do Sul, 90040-060 Porto Alegre, Brazil;
| | - Michele De Nes
- Biomedicine Department, CNR, Institute of Clinical Physiology, 56124 Pisa, Italy; (M.D.N.); (C.C.); (E.P.)
| | - Miodrag Ostojic
- Clinical Center of The Republic of Srpska, Faculty of Medicine, University of Banja-Luka, 78000 Banja-Luka, Bosnia and Herzegovina; (T.B.); (M.O.); (T.K.-P.)
| | - Clara Carpeggiani
- Biomedicine Department, CNR, Institute of Clinical Physiology, 56124 Pisa, Italy; (M.D.N.); (C.C.); (E.P.)
| | - Tamara Kovačević-Preradović
- Clinical Center of The Republic of Srpska, Faculty of Medicine, University of Banja-Luka, 78000 Banja-Luka, Bosnia and Herzegovina; (T.B.); (M.O.); (T.K.-P.)
| | - Jorge Lowenstein
- Cardiodiagnosticos, Investigaciones Medicas, C1082 ACB Buenos Aires, Argentina; (R.A.); (P.M.M.); (D.M.L.H.); (J.L.)
| | - Adelaide M. Arruda-Olson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55901, USA; (A.M.A.-O.); (P.A.P.)
| | - Patricia A. Pellikka
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55901, USA; (A.M.A.-O.); (P.A.P.)
| | - Eugenio Picano
- Biomedicine Department, CNR, Institute of Clinical Physiology, 56124 Pisa, Italy; (M.D.N.); (C.C.); (E.P.)
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Ciampi Q, Zagatina A, Cortigiani L, Gaibazzi N, Borguezan Daros C, Zhuravskaya N, Wierzbowska-Drabik K, Kasprzak JD, de Castro e Silva Pretto JL, D'Andrea A, Djordjevic-Dikic A, Monte I, Simova I, Boshchenko A, Citro R, Amor M, Merlo PM, Dodi C, Rigo F, Gligorova S, Dekleva M, Severino S, Lattanzi F, Scali MC, Vrublevsky A, Torres MA, Salustri A, Rodrìguez-Zanella H, Costantino FM, Varga A, Bossone E, Colonna P, De Nes M, Paterni M, Carpeggiani C, Lowenstein J, Gregori D, Picano E. Functional, Anatomical, and Prognostic Correlates of Coronary Flow Velocity Reserve During Stress Echocardiography. J Am Coll Cardiol 2019; 74:2278-2291. [DOI: 10.1016/j.jacc.2019.08.1046] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 08/08/2019] [Accepted: 08/12/2019] [Indexed: 02/07/2023]
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Scali MC, Zagatina A, Ciampi Q, Cortigiani L, D'Andrea A, Djordjevic-Dikic A, Merlo PM, Lattanzi F, Simova I, Monte I, Dodi C, Kasprzak JD, Galderisi M, Boshchenko A, Rigo F, Varga A, Dekleva M, Re F, de Castro e Silva Pretto JL, Zhuravaskaya N, Wierzbowska-Drabik K, Coviello K, Citro R, Colonna P, Carpeggiani C, Picano E. The Functional Meaning of B-Profile During Stress Lung Ultrasound. JACC Cardiovasc Imaging 2019; 12:928-930. [DOI: 10.1016/j.jcmg.2018.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/17/2018] [Accepted: 10/18/2018] [Indexed: 10/27/2022]
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Scali MC, Ciampi Q, Picano E, Bossone E, Ferrara F, Citro R, Colonna P, Costantino MF, Cortigiani L, Andrea AD, 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, de Castro e Silva Pretto JL, Miglioranza MH, Torres MAR, de Azevedo Bellagamba CC, Chaves DQ, Simova I, Varga A, Čelutkienė 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, Carpeggiani C. Quality control of B-lines analysis in stress Echo 2020. Cardiovasc Ultrasound 2018; 16:20. [PMID: 30249305 PMCID: PMC6154410 DOI: 10.1186/s12947-018-0138-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 08/03/2018] [Indexed: 01/06/2023] Open
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 < .01), the first attempt success rate was higher (43 vs 28%, p < 0.01), and the drop-out of readers smaller (0 vs 28%, p < .01). CONCLUSIONS Web-based learning is highly effective for teaching and harmonizing B-lines reading. Echocardiographers without previous experience with B-lines learn quickly.
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Affiliation(s)
- Maria Chiara Scali
- Cardiology Department, Nottola Hospital, Siena, Italy
- Cardiothoracic Department, University of Pisa, Pisa, Italy
| | - Quirino Ciampi
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Eugenio Picano
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
| | - Eduardo Bossone
- Cardiology Department, Ospedale santa Maria Incoronata dell’Olmo, cava de’ Tirreni, Salerno, Italy
| | - Francesco Ferrara
- Cardiology Department, Ospedale santa Maria Incoronata dell’Olmo, cava de’ Tirreni, Salerno, Italy
| | - Rodolfo Citro
- Cardiology Department and Echocardiography Lab, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico of Bari, Bari, Italy
| | | | | | - Antonello D’. Andrea
- Cardiology Department, Echocardiography Lab, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Sergio Severino
- Cardiology Department, Echocardiography Lab, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Claudio Dodi
- Casa di Cura Figlie di San Camillo, Cremona, Italy
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Parma, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | - Andrea Barbieri
- Cardiology Department, Modena University Hospital, Modena, Italy
| | - Ines Monte
- Cardio-Thorax-Vascular Department, Echocardiography lab, Policlinico Vittorio Emanuele, University of Catania, Catania, Italy
| | - Fabio Mori
- Cardiology Department, Careggi Hospital, Florence, Italy
| | - Barbara Reisenhofer
- Cardiology Division, Pontedera-Volterra Hospital, ASL Toscana 3 Nord-Ovest, Florence, Italy
| | - Federica Re
- Cardiology Department, San Camillo-Forlanini Hospital, Rome, Italy
| | - Fausto Rigo
- Cardiology Department, Ospedale dell’Angelo Mestre-Venice, Venice, Italy
| | | | - Miguel Amor
- Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - Jorge Lowenstein
- Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina
| | | | | | | | | | - Marco A. R. Torres
- Hospital de Clinicas de Porto Alegre - Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Iana Simova
- Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria
| | - Albert Varga
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Jelena Čelutkienė
- Centre of Cardiology and Angiology, Vilnius University Hospital Santaros Klinikos, Faculty of Medicine, Vilnius University, State Research Institute for Innovative Medicine, Vilnius, Lithuania
| | | | | | - Piotr Lipiec
- Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland
| | - Paulina Weiner-Mik
- Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland
| | - Eva Szymczyk
- Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland
| | | | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | | | - Ivan Stankovic
- Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar N. Neskovic
- Department of Cardiology, Clinical Hospital Center Zemun, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Angela Zagatina
- Cardiology Department, University Hospital, Saint Petersburg, Russian Federation
| | | | - Julio E. Perez
- Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, MO USA
| | - Ana Cristina Camarozano
- Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà, Curitiba, Brazil
| | - Anca Irina Corciu
- Department of Cardiology, IRCCS Policlinico San Donato Clinic, Milan, Italy
| | - Alla Boshchenko
- Cardiology Research Institute, Tomsk National Research Medical Center of Russian Academy of Sciences, Tomsk, Russia
| | - Fabio Lattanzi
- Cardiothoracic Department, University of Pisa, Pisa, Italy
| | - Carlos Cotrim
- Heart Center, Hospital da Cruz Vermelha, Lisbon and Medical School of University of Algarve, Faro, Portugal
| | - Paula Fazendas
- Cardiology Department, Hospital Garcia de Orta, Almada, Portugal
| | - Maciej Haberka
- Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Bozena Sobkowic
- Department of Cardiology, Medical University of Białystok, Białystok, Poland
| | - Wojciech Kosmala
- Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Witkowski
- Department of Cardiology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Gosciniak
- Department of Cardiology, Provincial Hospital, Szczecin, Poland
| | | | | | | | | | | | - Madalina-Loredana Urluescu
- Cardiology Department, County Hospital Sibiu, Invasive and Non-Invasive Center for Cardiac and Vascular Pathology in Adults - CVASIC Sibiu, Faculty of Medicine, Sibiu, Romania
| | - Maria Fiorino
- Cardiology Division Ospedale Civico Di Cristina Benfratelli, Palermo, Italy
| | | | | | - Miodrag Ostojic
- Institute for Cardiovascular Diseases, Dedinje, Belgrade, Italy
- University Clinical Center, Banja Luka, Republic of Srpska Bosnia and Herzegovina
| | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Michele De Nes
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
| | - Marco Paterni
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
| | - Clara Carpeggiani
- CNR, Institute of Clinical Physiology, Biomedicine Department, Pisa, Italy
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Picano E, Ciampi Q, Citro R, D’Andrea A, Scali MC, Cortigiani L, Olivotto I, Mori F, Galderisi M, Costantino MF, Pratali L, Di Salvo G, Bossone E, Ferrara F, Gargani L, Rigo F, Gaibazzi N, Limongelli G, Pacileo G, Andreassi MG, Pinamonti B, Massa L, Torres MAR, Miglioranza MH, Daros CB, de Castro e Silva Pretto JL, Beleslin B, Djordjevic-Dikic A, Varga A, Palinkas A, Agoston G, Gregori D, Trambaiolo P, Severino S, Arystan A, Paterni M, Carpeggiani C, Colonna P. Stress echo 2020: the international stress echo study in ischemic and non-ischemic heart disease. Cardiovasc Ultrasound 2017; 15:3. [PMID: 28100277 PMCID: PMC5242057 DOI: 10.1186/s12947-016-0092-1] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information. The study is endorsed by the Italian Society of Cardiovascular Echography and organized in 10 subprojects focusing on: contractile reserve for prediction of cardiac resynchronization or medical therapy response; stress B-lines in heart failure; hypertrophic cardiomyopathy; heart failure with preserved ejection fraction; mitral regurgitation after either transcatheter or surgical aortic valve replacement; outdoor SE in extreme physiology; right ventricular contractile reserve in repaired Tetralogy of Fallot; suspected or initial pulmonary arterial hypertension; coronary flow velocity, left ventricular elastance reserve and B-lines in known or suspected CAD; identification of subclinical familial disease in genotype-positive, phenotype- negative healthy relatives of inherited disease (such as hypertrophic cardiomyopathy). RESULTS We expect to recruit about 10,000 patients over a 5-year period (2016-2020), with sample sizes ranging from 5,000 for coronary flow velocity/ left ventricular elastance/ B-lines in CAD to around 250 for hypertrophic cardiomyopathy or repaired Tetralogy of Fallot. This data-base will allow to investigate technical questions such as feasibility and reproducibility of various SE parameters and to assess their prognostic value in different clinical scenarios. CONCLUSIONS The study will create the cultural, informatic and scientific infrastructure connecting high-volume, accredited SE labs, sharing common criteria of indication, execution, reporting and image storage of SE to obtain original safety, feasibility, and outcome data in evidence-poor diagnostic fields, also outside the established core application of SE in CAD based on regional wall motion abnormalities. The study will standardize procedures, validate emerging signs, and integrate the new information with established knowledge, helping to build a next-generation SE lab without inner walls.
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Affiliation(s)
- Eugenio Picano
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Rodolfo Citro
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Antonello D’Andrea
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | - Maria Chiara Scali
- Cardiology Department, Pisa University and Nottola (Siena) Hospital, Pisa, Italy
| | | | | | - Fabio Mori
- Cardiology Department, Careggi Hospital, Florence, Italy
| | - Maurizio Galderisi
- Department of Advanced Biomedical Sciences, Federico II University Hospital, Naples, Italy
| | | | - Lorenza Pratali
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | | | - Eduardo Bossone
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Francesco Ferrara
- Heart Department, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
| | - Luna Gargani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Fausto Rigo
- Division of Cardiology, Ospedale dell’Angelo Mestre-Venice, Mestre, Italy
| | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Parma, Italy
| | | | - Giuseppe Pacileo
- Division of Cardiology, Monaldi Hospital, Second University of Naples, Naples, Italy
| | | | - Bruno Pinamonti
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Laura Massa
- Cardiology Department, University Hospital “Ospedale Riuniti”, Trieste, Italy
| | - Marco A. R. Torres
- Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Albert Varga
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Attila Palinkas
- Department of Internal Medicine, Elisabeth Hospital, Hodmezovasarhely, Hungary
| | - Gergely Agoston
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Dario Gregori
- Department of Biostatistics, University of Padua, Padua, Italy
| | | | | | - Ayana Arystan
- RSE, Medical Centre Hospital of the President’s Affairs Administration of the Republic of Kazakhstan, Astana, Kazakhstan
| | - Marco Paterni
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Clara Carpeggiani
- Institute of Clinical Physiology, National Research Council, Pisa, Italy
| | - Paolo Colonna
- Cardiology Hospital, Policlinico of Bari, Bari, Italy
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