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

Autor:	Woodward W; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK., Dockerill C; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK., McCourt A; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK., Upton R; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK.; Ultromics Ltd, Wood Centre for Innovation, OxfordOX3 8SB, UK., O'Driscoll J; Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK.; School of Human and Life Sciences, Canterbury Christ Church University, Canterbury CT1 1QU, UK., Balkhausen K; Department of Cardiology, Royal Berkshire Hospitals NHS Foundation Trust, Reading RG1 5AN, UK., Chandrasekaran B; Department of Cardiology, Great Western Hospitals NHS Foundation Trust, Swindon SN3 6BB, UK., Firoozan S; Department of Cardiology, Buckinghamshire Healthcare NHS Trust, High Wycombe HP11 2TT, UK., Kardos A; Department of Cardiology, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes MK6 5LD, UK., Wong K; Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool FY3 8NP, UK., Woodward G; Ultromics Ltd, Wood Centre for Innovation, OxfordOX3 8SB, UK., Sarwar R; Ultromics Ltd, Wood Centre for Innovation, OxfordOX3 8SB, UK.; Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK., Sabharwal N; Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK., Benedetto E; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK., Spagou N; Ultromics Ltd, Wood Centre for Innovation, OxfordOX3 8SB, UK., Sharma R; Department of Cardiology, St George's University Hospitals NHS Foundation Trust, London SW17 0QT, UK., Augustine D; Department of Cardiology, Royal United Hospitals NHS Foundation Trust, Bath, BA1 3NG, UK., Tsiachristas A; Health Economic Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK., Senior R; National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK.; Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NJ, UK.; Department of Cardiology, London North West University Healthcare NHS Trust, London HA1 3UJ, UK., Leeson P; Cardiovascular Clinical Research Facility, RDM Division of Cardiovascular Medicine, University of Oxford, Oxford OX3 9DU, UK., Boardman H; Department of Cardiology, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes MK6 5LD, UK.; Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK., d'Arcy J; Oxford Heart Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK., Abraheem A; Department of Cardiology, Tameside and Glossop Integrated Care NHS Foundation Trust, Ashton-under-Lyne, UK., Banypersad S; Department of Cardiology, East Lancashire Hospitals NHS Trust, Burnley, UK., Boos C; Department of Cardiology, Poole Hospital NHS Foundation Trust, Poole, UK., Bulugahapitiya S; Department of Cardiology, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK., Butts J; Department of Cardiology, Calderdale and Huddersfield NHS Foundation Trust, Calderdale, UK., Coles D; Department of Cardiology, Mid Essex NHS Hospital Services NHS Trust, Broomfield, UK., Easaw J; Department of Cardiology, Royal United Hospitals NHS Foundation Trust, Bath, BA1 3NG, UK., Hamdan H; Department of Cardiology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK., Jamil-Copley S; Department of Cardiology, Nottingham University Hospitals NHS Trust, Nottingham, UK., Kanaganayagam G; Department of Cardiology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK., Mwambingu T; Department of Cardiology, The Mid Yorkshire Hospitals NHS Trust, Pinderfields, UK., Pantazis A; Department of Cardiology, North Middlesex University Hospital NHS Trust, London, UK., Papachristidis A; Department of Cardiology, King's College Hospital NHS Foundation Trust, London, UK., Rajani R; Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK., Rasheed MA; Department of Cardiology, Yeovil District Hospital NHS Foundation Trust, Yeovil, UK., Razvi NA; Department of Cardiology, East Suffolk and North Essex NHS Foundation Trust, Ipswich, UK., Rekhraj S; Department of Cardiology, Nottingham University Hospitals NHS Trust, Nottingham, UK., Ripley DP; Department of Cardiology, Northumbria Healthcare NHS Foundation Trust, North Tyneside, UK., Rose K; Department of Cardiology, Northampton General Hospital NHS Trust, Northampton, UK., Scheuermann-Freestone M; Department of Cardiology, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK., Schofield R; Department of Cardiology, North West Anglia NHS Foundation Trust, Peterborough, UK., Sultan A; Department of Cardiology, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK.
Jazyk:	angličtina
Zdroj:	European heart journal. Cardiovascular Imaging [Eur Heart J Cardiovasc Imaging] 2022 Apr 18; Vol. 23 (5), pp. 689-698.
DOI:	10.1093/ehjci/jeab092
Abstrakt:	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.)
Databáze:	MEDLINE
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