Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes
| Autor: | Ana Djordjevic-Dikic, Maria Grazia D'Alfonso, Karina Wierzbowska-Drabik, Jarosław D. Kasprzak, Clarissa Borguezan Daros, Clara Carpeggiani, Tamara Ryabova, Elisa Merli, Michele De Nes, Nikola Boskovic, Jorge Lowenstein, Miguel Amor, Jesús Peteiro, Pablo Merlo, Angela Zagatina, Lauro Cortigiani, José Luis de Castro e Silva Pretto, Alla A. Boshchenko, Doralisa Morrone, Milica Dekleva, Maria Chiara Scali, Giuseppe Limongelli, Federica Re, Ana Cristina Camarozano, Milorad Tesic, Iana Simova, Francesco Antonini-Canterin, Diego M. Lowenstein Haber, Quirino Ciampi, Fabio Lattanzi, Paolo Colonna, R Arbucci, Ines Monte, Valentina Lorenzoni, Nicola Gaibazzi, Fabio Mori, Branko Beleslin, Paul E Vargas Mieles, Hugo Rodríguez-Zanella, Giovanni Di Salvo, Gergely Ágoston, Bruno Villari, Marco Paterni, Eugenio Picano, Albert Varga, Rodolfo Citro, Marco Antonio Rodrigues Torres, Antonello D'Andrea, Costantina Prota, Nadezhda Zhuravskaya |
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| Přispěvatelé: | Morrone, D., Arbucci, R., Wierzbowska-Drabik, K., Ciampi, Q., Peteiro, J., Agoston, G., Varga, A., Camarozano, A. C., Boshchenko, A., Ryabova, T., Dekleva, M., Simova, I., Lowenstein Haber, D. M., Tesic, M., Boskovic, N., Djordjevic-Dikic, A., Beleslin, B., D'Alfonso, M. G., Mori, F., Rodriguez-Zanella, H., Kasprzak, J. D., Cortigiani, L., Lattanzi, F., Scali, M. C., Torres, M. A. R., Daros, C. B., de Castro e Silva Pretto, J. L., Gaibazzi, N., Zagatina, A., Zhuravskaya, N., Amor, M., Mieles, P. E. V., Merlo, P. M., Monte, I., D'Andrea, A., Re, F., Di Salvo, G., Merli, E., Lorenzoni, V., De Nes, M., Paterni, M., Limongelli, G., Prota, C., Citro, R., Colonna, P., Villari, B., Antonini-Canterin, F., Carpeggiani, C., Lowenstein, J., Picano, E. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Male
Vasodilator Agents Vasodilation Coronary Artery Disease 030204 cardiovascular system & hematology Logistic regression 0302 clinical medicine Atrial Pressure Left atrial Dobutamine 030212 general & internal medicine Prospective Studies Cardiac imaging Aged 80 and over Dipyridamole Echocardiography Exercise Left atrial volume Stress Syndrome Middle Aged Europe Italy Adrenergic beta-1 Receptor Agonists Cardiology Atrial Function Left Female medicine.symptom Cardiology and Cardiovascular Medicine Brazil medicine.drug Echocardiography Stress medicine.medical_specialty Argentina Asymptomatic 03 medical and health sciences Predictive Value of Tests Internal medicine medicine Stress Echocardiography Humans Radiology Nuclear Medicine and imaging Heart Atria Aged Echocardiography Doppler Pulsed business.industry Chronic Disease Feasibility Studies business |
| Popis: | 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 ± 12years) 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 ≥ 6.8ml/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. |
| Databáze: | OpenAIRE |
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