TY - JOUR

T1 - Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes

AU - Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography

AU - Morrone, Doralisa

AU - Arbucci, Rosina

AU - Wierzbowska-Drabik, Karina

AU - Ciampi, Quirino

AU - Peteiro, Jesus

AU - Agoston, Gergely

AU - Varga, Albert

AU - Camarozano, Ana Cristina

AU - Boshchenko, Alla

AU - Ryabova, Tamara

AU - Dekleva, Milica

AU - Simova, Iana

AU - Lowenstein Haber, Diego M.

AU - Tesic, Milorad

AU - Boskovic, Nikola

AU - Djordjevic-Dikic, Ana

AU - Beleslin, Branko

AU - D’Alfonso, Maria Grazia

AU - Mori, Fabio

AU - Rodrìguez-Zanella, Hugo

AU - Kasprzak, Jaroslaw D.

AU - Cortigiani, Lauro

AU - Lattanzi, Fabio

AU - Scali, Maria Chiara

AU - Torres, Marco A.R.

AU - Daros, Clarissa Borguezan

AU - de Castro e Silva Pretto, José Luis

AU - Gaibazzi, Nicola

AU - Zagatina, Angela

AU - Zhuravskaya, Nadezhda

AU - Amor, Miguel

AU - Mieles, Paul E.Vargas

AU - Merlo, Pablo Martin

AU - Monte, Ines

AU - D’Andrea, Antonello

AU - Re, Federica

AU - Di Salvo, Giovanni

AU - Merli, Elisa

AU - Lorenzoni, Valentina

AU - De Nes, Michele

AU - Paterni, Marco

AU - Limongelli, Giuseppe

AU - Prota, Costantina

AU - Citro, Rodolfo

AU - Colonna, Paolo

AU - Villari, Bruno

AU - Antonini-Canterin, Francesco

AU - Carpeggiani, Clara

AU - Lowenstein, Jorge

AU - Picano, Eugenio

N1 - Funding Information: All patients underwent SE testing as part of a clinically-driven work-up and according to the referring physician's indications. Written informed consent was obtained from all patients before testing. The study protocol was reviewed and approved by the institutional ethics committees as a part of the SE 2020 study (148-Comitato Etico Lazio-1, July 16, 2016; Clinical trials. Gov Identifier NCT 030.49995). The study was funded partly by travel grants of the Italian Society of Echocardiography and Cardiovascular Imaging with dedicated sessions during national meetings. No support from industry was received. Publisher Copyright: © 2020, Springer Nature B.V. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2021/3

Y1 - 2021/3

N2 - An enlarged left atrial volume index (LAVI) at rest mirrors increased LA pressure and/or impairment of LA function. A cardiovascular stress may acutely modify left atrial volume (LAV) within minutes. Aim of this study was to assess the feasibility and functional correlates of LAV-stress echocardiography (SE) Out of 514 subjects referred to 10 quality-controlled labs, LAV-SE was completed in 490 (359 male, age 67 ± 12 years) with suspected or known chronic coronary syndromes (n = 462) or asymptomatic controls (n = 28). The utilized stress was exercise in 177, vasodilator in 167, dobutamine in 146. LAV was measured with the biplane disk summation method. SE was performed with the ABCDE protocol. The intra-observer and inter-observer LAV variability were 5% and 8%, respectively. ∆-LAVI changes (stress-rest) were negatively correlated with resting LAVI (r = − 0.271, p < 0.001) and heart rate reserve (r = -.239, p < 0.001). LAV-dilators were defined as those with stress-rest increase ≥ 6.8 ml/m2, a cutoff derived from a calculated reference change value above the biological, analytical and observer variability of LAVI. LAV dilation occurred in 56 patients (11%), more frequently with exercise (16%) and dipyridamole (13%) compared to dobutamine (4%, p < 0.01). At multivariable logistic regression analysis, B-lines ≥ 2 (OR: 2.586, 95% CI = 1.1293–5.169, p = 0.007) and abnormal contractile reserve (OR: 2.207, 95% CI = 1.111–4.386, p = 0.024) were associated with LAV dilation. In conclusion, LAV-SE is feasible with high success rate and low variability in patients with chronic coronary syndromes. LAV dilation is more likely with reduced left ventricular contractile reserve and pulmonary congestion.

AB - An enlarged left atrial volume index (LAVI) at rest mirrors increased LA pressure and/or impairment of LA function. A cardiovascular stress may acutely modify left atrial volume (LAV) within minutes. Aim of this study was to assess the feasibility and functional correlates of LAV-stress echocardiography (SE) Out of 514 subjects referred to 10 quality-controlled labs, LAV-SE was completed in 490 (359 male, age 67 ± 12 years) with suspected or known chronic coronary syndromes (n = 462) or asymptomatic controls (n = 28). The utilized stress was exercise in 177, vasodilator in 167, dobutamine in 146. LAV was measured with the biplane disk summation method. SE was performed with the ABCDE protocol. The intra-observer and inter-observer LAV variability were 5% and 8%, respectively. ∆-LAVI changes (stress-rest) were negatively correlated with resting LAVI (r = − 0.271, p < 0.001) and heart rate reserve (r = -.239, p < 0.001). LAV-dilators were defined as those with stress-rest increase ≥ 6.8 ml/m2, a cutoff derived from a calculated reference change value above the biological, analytical and observer variability of LAVI. LAV dilation occurred in 56 patients (11%), more frequently with exercise (16%) and dipyridamole (13%) compared to dobutamine (4%, p < 0.01). At multivariable logistic regression analysis, B-lines ≥ 2 (OR: 2.586, 95% CI = 1.1293–5.169, p = 0.007) and abnormal contractile reserve (OR: 2.207, 95% CI = 1.111–4.386, p = 0.024) were associated with LAV dilation. In conclusion, LAV-SE is feasible with high success rate and low variability in patients with chronic coronary syndromes. LAV dilation is more likely with reduced left ventricular contractile reserve and pulmonary congestion.

KW - Dipyridamole

KW - Dobutamine

KW - Echocardiography

KW - Exercise

KW - Left atrial volume

KW - Stress

KW - INFUSION

KW - EUROPEAN ASSOCIATION

KW - FAILURE

KW - RESERVE

KW - RECOMMENDATIONS

KW - UPDATE

KW - INDEX

KW - AMERICAN SOCIETY

UR - http://www.scopus.com/inward/record.url?scp=85092553598&partnerID=8YFLogxK

UR - https://www.mendeley.com/catalogue/41fa1ad2-c02b-3224-b74a-00be84485f6e/

U2 - 10.1007/s10554-020-02071-5

DO - 10.1007/s10554-020-02071-5

M3 - Article

AN - SCOPUS:85092553598

VL - 37

SP - 953

EP - 964

JO - International Journal of Cardiovascular Imaging

JF - International Journal of Cardiovascular Imaging

SN - 1569-5794

IS - 3

ER -