Evidence map›Paper›PMID 32036487›Full record

ArticleThe international journal of cardiovascular imaging2020

Exercise stress echocardiography with ABCDE protocol in unexplained dyspnoea.

Angela Zagatina, Nadezhda Zhuravskaya, Dmitry Shmatov, Quirino Ciampi, Clara Carpeggiani, Eugenio Picano, Stress Echo 2020 study group of the Italian Society of Echocardiography, Cardiovascular Imaging

Registry-linked trialAbstract read
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In one paragraph

Article in The international journal of cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05081115 (The International Stress Echo Study to to Define the Future of Imaging), which is not on this map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05081115 recruitingnot on this mapstarted 2021, after this paper: background citation

The International Stress Echo Study to to Define the Future of Imaging

Typeobservational_patient_registrySponsorFatebenefratelli HospitalRan2021 to 2030Enrolled10,000ConditionsCoronary Artery Disease, Heart Failure, Hypertrophic Cardiomyopathy, Congenital Heart DiseaseArmsABCDE-Stress Echo, SE diastolic assessment, SE Right ventricular function assessment, SE in heart donors
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 17 citations in OpenAlex.

  1. Review
  2. Review
  3. Exercise stress echocardiography: Where are we now?World journal of cardiology · 2022
    Review
  4. Article
  5. Review
  6. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Angela ZagatinaSaint Petersburg State University Hospital, Saint Petersburg, Russian Federation.
Nadezhda ZhuravskayaSaint Petersburg State University Hospital, Saint Petersburg, Russian Federation.
Dmitry ShmatovSaint Petersburg State University Hospital, Saint Petersburg, Russian Federation.
Quirino CiampiCardiology Division, Fatebenefratelli Hospital, Benevento, Italy.
Clara CarpeggianiBiomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy.
Eugenio PicanoBiomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy. picano@ifc.cnr.it.ORCID http://orcid.org/0000-0002-6375-6361
Stress Echo 2020 study group of the Italian Society of Echocardiography, Cardiovascular Imaging
St Petersburg University · RUCluster in Biomedicine · ITIstituto di Fisiologia Clinica · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Current guidelines recommend the use of exercise stress echocardiography (ESE) in patients with unexplained dyspnoea. SE was recently reshaped with the ABCDE protocol: A for asynergy, B for B-lines (4-site simplified scan), C for contractile reserve based on force, D for Doppler-based coronary flow velocity reserve (CFVR) in left anterior descending coronary artery; and E for EKG-based heart rate reserve (HRR, defined as peak/rest HR < 1.62). Aim of the study was to define the ESE response in patients with dyspnoea as the main symptom. From the initial population of patients referred in 2018 in a single center for semi-supine ESE, we selected two groups (without history of previous myocardial infarction or coronary revascularization) on the basis of the main presenting symptom: dyspnoea (Group 1, n = 100, 62 men, 63 ± 10 years) or chest pain (Group 2, n = 100, 58 men, age 61 ± 8 years). All underwent ESE with ABCDE protocol. Success rate was 100% for steps A, B, C, E, and 88% for step D. Positivity for A criterion occurred in 56 patients of Group 1 and 24 of Group 2 (p < 0.0001). B-lines positivity (stress > rest for ≥ 2 points) occurred in 40 patients of Group 1 and 28 of Group 2 (p = 0.07). LVCR positivity (< 2.0) occurred in 60 patients of Group 1 and 42 of Group 2 (p < 0.05). A reduced CFVR occurred in 56 of Group 1 and 22 of Group 2 (p < 0.0001). A blunted HRR was present in 44 patients of Group 1 and 22 of Group 2 (p < 0.001). In conclusion, in patients with unexplained dyspnoea, SE with ABCDE protocol is useful to document the cardiac origin of dyspnoea with a comprehensive assessment focused not only on ischemia (A) but also pulmonary congestion (B), myocardial scar or necrosis (C), coronary microvascular dysfunction (D) or chronotropic incompetence (E).

Indexed as

Echocardiography, Doppler, ColorEchocardiography, Doppler, PulsedExercise TestAgedBlood Flow VelocityCoronary CirculationDyspneaEchocardiography, StressElectrocardiographyFemaleHeart DiseasesHeart RateHumansMaleMiddle AgedMyocardial ContractionCoronary flow velocity reserveHeart failureStress echocardiography

Identifiers

PMID32036487
OpenAlexW3005057720

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.