Prognostic value of stress echocardiography assessed by the ABCDE protocol.
Prognostic value of stress echocardiography assessed by the ABCDE protocol.
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DOI：
10.1093/eurheartj/ehab493
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发表时间：
2021-10-01
影响因子：
39.3
通讯作者：
Picano E
中科院分区：
文献类型：
--
作者：
Ciampi Q;Zagatina A;Cortigiani L;Wierzbowska-Drabik K;Kasprzak JD;Haberka M;Djordjevic-Dikic A;Beleslin B;Boshchenko A;Ryabova T;Gaibazzi N;Rigo F;Dodi C;Simova I;Samardjieva M;Barbieri A;Morrone D;Lorenzoni V;Prota C;Villari B;Antonini-Canterin F;Pepi M;Carpeggiani C;Pellikka PA;Picano E
本研究的目的是在一项前瞻性、大规模、多中心、国际性、有效性研究中评估ABCDE-SE的预后价值。负荷超声心动图(SE)最近被升级为ABCDE方案：步骤A，节段性室壁运动异常；步骤B，B线；步骤C，左心室收缩储备；步骤D，基于多普勒的冠状动脉左前降支血流储备；步骤E，基于心电图的心率储备。从2016年7月至2020年11月，我们纳入了来自13个认证实验室的3574名慢性冠脉综合征患者(年龄65 ± 11 岁，2070名男性，58%；射血分数60 ± 10%)。所有患者均接受了临床表现的ABCDE-SE检查。采用的应激方式是运动(n = 952，半仰卧式自行车，n = 887，或跑步机，n = 65，D步加腺苷)或药物应激(n = 2622，加血管扩张剂，n = 2151；或多巴酚丁胺，n = 471)。SE反应从0分(所有步骤正常)到5分(所有步骤异常)。全因死亡是唯一的终点。结果异常率A组为16%，B组为30%，C组为36%，D组为28%，E组为37%。在中位数21个 月(四分位数范围：13-36)的随访中，发生了73例死亡。考虑到临床变量，全局X2为49.5%，仅在A步后为50.7%(P = NS(不显著))，在B-E步后为80.6%(P <； 0.001 vs.A步)。0分的年死亡率为0.4%，5分的年死亡率为2.7%。ABCDE-SE可有效预测慢性冠脉综合征患者的存活率。这项研究招募了来自5个国家和地区的13个压力回声实验室的3574名患者，并展示了使用压力回波ABCDE新的最先进的心功能测试的预后价值：步骤A用于节段性室壁运动异常；步骤B用于通过四点简化扫描和肺部超声获得的B线；步骤C用于容量超声心动图的收缩储备；步骤D用于基于多普勒的冠状动脉中远端前降支血流储备的评估；步骤E用于基于EKG的心率储备。
The aim of this study was to assess the prognostic value of ABCDE-SE in a prospective, large scale, multicentre, international, effectiveness study. Stress echocardiography (SE) was recently upgraded to the ABCDE protocol: step A, regional wall motion abnormalities; step B, B lines; step C, left ventricular contractile reserve; step D, Doppler-based coronary flow velocity reserve in left anterior descending coronary artery; and step E, electrocardiogram-based heart rate reserve. From July 2016 to November 2020, we enrolled 3574 all-comers (age 65 ± 11 years, 2070 males, 58%; ejection fraction 60 ± 10%) with known or suspected chronic coronary syndromes referred from 13 certified laboratories. All patients underwent clinically indicated ABCDE-SE. The employed stress modality was exercise (n = 952, with semi-supine bike, n = 887, or treadmill, n = 65 with adenosine for step D) or pharmacological stress (n = 2622, with vasodilator, n = 2151; or dobutamine, n = 471). SE response ranged from score 0 (all steps normal) to score 5 (all steps abnormal). All-cause death was the only endpoint. Rate of abnormal results was 16% for A, 30% for B, 36% for C, 28% for D, and 37% for E steps. During a median follow-up of 21 months (interquartile range: 13–36), 73 deaths occurred. Global X 2 was 49.5 considering clinical variables, 50.7 after step A only (P = NS (not significant)) and 80.6 after B–E steps (P < 0.001 vs. step A). Annual mortality rate ranged from 0.4% person-year for score 0 up to 2.7% person-year for score 5. ABCDE-SE allows an effective prediction of survival in patients with chronic coronary syndromes. This study recruited 3,574 patients from 13 stress echo laboratories of 5 countries and shows the prognostic value of the new state-of-the art cardiac functional testing with stress echo ABCDE protocol: Step A for regional wall motion abnormalities; step B for B-lines obtained with 4-site simplified scan and lung ultrasound; step C for contractile reserve with volumetric echocardiography; step D for Doppler-based assessment of coronary flow reserve in mid-distal left anterior descending coronary artery; step E for EKG-based heart rate reserve.
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影响因子：
2.8
作者：
Cortigiani, Lauro;Carpeggiani, Clara;Picano, Eugenio
通讯作者：
Picano, Eugenio
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe
影响因子：
24
作者：
Ciampi, Quirino;Zagatina, Angela;Picano, Eugenio
通讯作者：
Picano, Eugenio
影响因子：
39.3
作者：
Chaowalit, Nithima;McCully, Robert B.;Pellikka, Patricia A.
通讯作者：
Pellikka, Patricia A.
影响因子：
3
作者：
Cortigiani, Lauro;Ciampi, Quirino;Picano, Eugenio
通讯作者：
Picano, Eugenio