Research output: Contribution to journal › Article › peer-review
Lung Ultrasound and Pulmonary Congestion During Stress Echocardiography. / Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography.
In: JACC: Cardiovascular Imaging, Vol. 13, No. 10, 10.2020, p. 2085-2095.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Lung Ultrasound and Pulmonary Congestion During Stress Echocardiography
AU - Stress Echo 2020 study group of the Italian Society of Cardiovascular Echography
AU - Scali, Maria Chiara
AU - Zagatina, Angela
AU - Ciampi, Quirino
AU - Cortigiani, Lauro
AU - D'Andrea, Antonello
AU - Daros, Clarissa Borguezan
AU - Zhuravskaya, Nadezhda
AU - Kasprzak, Jaroslaw D.
AU - Wierzbowska-Drabik, Karina
AU - Luis de Castro e Silva Pretto, José
AU - Djordjevic-Dikic, Ana
AU - Beleslin, Branko
AU - Petrovic, Marija
AU - Boskovic, Nikola
AU - Tesic, Milorad
AU - Monte, Ines
AU - Simova, Iana
AU - Vladova, Martina
AU - Boshchenko, Alla
AU - Vrublevsky, Alexander
AU - Citro, Rodolfo
AU - Amor, Miguel
AU - Vargas Mieles, Paul E.
AU - Arbucci, Rosina
AU - Merlo, Pablo Martin
AU - Lowenstein Haber, Diego M.
AU - Dodi, Claudio
AU - Rigo, Fausto
AU - Gligorova, Suzana
AU - Dekleva, Milica
AU - Severino, Sergio
AU - Lattanzi, Fabio
AU - Morrone, Doralisa
AU - Galderisi, Maurizio
AU - Torres, Marco A.R.
AU - Salustri, Alessandro
AU - Rodrìguez-Zanella, Hugo
AU - Costantino, Fabio Marco
AU - Varga, Albert
AU - Agoston, Gergely
AU - Bossone, Eduardo
AU - Ferrara, Francesco
AU - Gaibazzi, Nicola
AU - Celutkiene, Jelena
AU - Haberka, Maciej
AU - Mori, Fabio
AU - D'Alfonso, Maria Grazia
AU - Reisenhofer, Barbara
AU - Camarozano, Ana Cristina
AU - Miglioranza, Marcelo Haertel
N1 - Publisher Copyright: © 2020 American College of Cardiology Foundation
PY - 2020/10
Y1 - 2020/10
N2 - Objectives: The purpose of this study was to assess the functional and prognostic correlates of B-lines during stress echocardiography (SE). Background: B-profile detected by lung ultrasound (LUS) is a sign of pulmonary congestion during SE. Methods: The authors prospectively performed transthoracic echocardiography (TTE) and LUS in 2,145 patients referred for exercise (n = 1,012), vasodilator (n = 1,054), or dobutamine (n = 79) SE in 11 certified centers. B-lines were evaluated in a 4-site simplified scan (each site scored from 0: A-lines to 10: white lung for coalescing B-lines). During stress the following were also analyzed: stress-induced new regional wall motion abnormalities in 2 contiguous segments; reduced left ventricular contractile reserve (peak/rest based on force, ≤2.0 for exercise and dobutamine, ≤1.1 for vasodilators); and abnormal coronary flow velocity reserve ≤2.0, assessed by pulsed-wave Doppler sampling in left anterior descending coronary artery and abnormal heart rate reserve (peak/rest heart rate) ≤1.80 for exercise and dobutamine (≤1.22 for vasodilators). All patients completed follow-up. Results: According to B-lines at peak stress patients were divided into 4 different groups: group I, absence of stress B-lines (score: 0 to 1; n = 1,389; 64.7%); group II, mild B-lines (score: 2 to 4; n = 428; 20%); group III, moderate B-lines (score: 5 to 9; n = 209; 9.7%) and group IV, severe B-lines (score: ≥10; n = 119; 5.4%). During median follow-up of 15.2 months (interquartile range: 12 to 20 months) there were 38 deaths and 28 nonfatal myocardial infarctions in 64 patients. At multivariable analysis, severe stress B-lines (hazard ratio [HR]: 3.544; 95% confidence interval [CI]: 1.466 to 8.687; p = 0.006), abnormal heart rate reserve (HR: 2.276; 95% CI: 1.215 to 4.262; p = 0.010), abnormal coronary flow velocity reserve (HR: 2.178; 95% CI: 1.059 to 4.479; p = 0.034), and age (HR: 1.031; 95% CI: 1.002 to 1.062; p = 0.037) were independent predictors of death and nonfatal myocardial infarction. Conclusions: Severe stress B-lines predict death and nonfatal myocardial infarction. (Stress Echo 2020 - The International Stress Echo Study [SE2020]; NCT03049995)
AB - Objectives: The purpose of this study was to assess the functional and prognostic correlates of B-lines during stress echocardiography (SE). Background: B-profile detected by lung ultrasound (LUS) is a sign of pulmonary congestion during SE. Methods: The authors prospectively performed transthoracic echocardiography (TTE) and LUS in 2,145 patients referred for exercise (n = 1,012), vasodilator (n = 1,054), or dobutamine (n = 79) SE in 11 certified centers. B-lines were evaluated in a 4-site simplified scan (each site scored from 0: A-lines to 10: white lung for coalescing B-lines). During stress the following were also analyzed: stress-induced new regional wall motion abnormalities in 2 contiguous segments; reduced left ventricular contractile reserve (peak/rest based on force, ≤2.0 for exercise and dobutamine, ≤1.1 for vasodilators); and abnormal coronary flow velocity reserve ≤2.0, assessed by pulsed-wave Doppler sampling in left anterior descending coronary artery and abnormal heart rate reserve (peak/rest heart rate) ≤1.80 for exercise and dobutamine (≤1.22 for vasodilators). All patients completed follow-up. Results: According to B-lines at peak stress patients were divided into 4 different groups: group I, absence of stress B-lines (score: 0 to 1; n = 1,389; 64.7%); group II, mild B-lines (score: 2 to 4; n = 428; 20%); group III, moderate B-lines (score: 5 to 9; n = 209; 9.7%) and group IV, severe B-lines (score: ≥10; n = 119; 5.4%). During median follow-up of 15.2 months (interquartile range: 12 to 20 months) there were 38 deaths and 28 nonfatal myocardial infarctions in 64 patients. At multivariable analysis, severe stress B-lines (hazard ratio [HR]: 3.544; 95% confidence interval [CI]: 1.466 to 8.687; p = 0.006), abnormal heart rate reserve (HR: 2.276; 95% CI: 1.215 to 4.262; p = 0.010), abnormal coronary flow velocity reserve (HR: 2.178; 95% CI: 1.059 to 4.479; p = 0.034), and age (HR: 1.031; 95% CI: 1.002 to 1.062; p = 0.037) were independent predictors of death and nonfatal myocardial infarction. Conclusions: Severe stress B-lines predict death and nonfatal myocardial infarction. (Stress Echo 2020 - The International Stress Echo Study [SE2020]; NCT03049995)
KW - coronary artery disease
KW - heart failure
KW - lung ultrasound
KW - stress echocardiography
KW - COMETS
KW - SIGN
KW - PROGNOSTIC VALUE
KW - WATER
UR - http://www.scopus.com/inward/record.url?scp=85089290503&partnerID=8YFLogxK
UR - https://www.mendeley.com/catalogue/4376993b-8df1-34d4-bc27-2db2f19db357/
U2 - 10.1016/j.jcmg.2020.04.020
DO - 10.1016/j.jcmg.2020.04.020
M3 - Article
C2 - 32682714
AN - SCOPUS:85089290503
VL - 13
SP - 2085
EP - 2095
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
SN - 1936-878X
IS - 10
ER -
ID: 62495872