Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes

Doralisa Morrone¹, Rosina Arbucci², Karina Wierzbowska-Drabik³, Quirino Ciampi⁴, Jesus Peteiro⁵, Gergely Agoston⁶, Albert Varga⁶, Ana Cristina Camarozano⁷, Alla Boshchenko⁸, Tamara Ryabova⁸, Milica Dekleva⁹, Iana Simova¹⁰, Diego M Lowenstein Haber², Milorad Tesic¹¹, Nikola Boskovic¹¹, Ana Djordjevic-Dikic¹¹, Branko Beleslin¹¹, Maria Grazia D'Alfonso¹², Fabio Mori¹², Hugo Rodrìguez-Zanella¹³, Jaroslaw D Kasprzak³, Lauro Cortigiani¹⁴, Fabio Lattanzi¹, Maria Chiara Scali¹, Marco A R Torres¹⁵, Clarissa Borguezan Daros¹⁶, José Luis de Castro E Silva Pretto¹⁷, Nicola Gaibazzi¹⁸, Angela Zagatina¹⁹, Nadezhda Zhuravskaya¹⁹, Miguel Amor²⁰, Paul E Vargas Mieles²⁰, Pablo Martin Merlo², Ines Monte²¹, Antonello D'Andrea²², Federica Re²³, Giovanni Di Salvo²⁴, Elisa Merli²⁵, Valentina Lorenzoni²⁶, Michele De Nes²⁷, Marco Paterni²⁷, Giuseppe Limongelli²⁸, Costantina Prota⁴, Rodolfo Citro^{29

30}, Paolo Colonna^{30

31}, Bruno Villari⁴, Francesco Antonini-Canterin^{30

32}, Clara Carpeggiani²⁷, Jorge Lowenstein², Eugenio Picano³³; Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging - Subproject all you need is LAV

Affiliations

¹ Cardiothoracic Department, University of Pisa, Pisa, Italy.
² Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina.
³ Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland.
⁴ Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy.
⁵ CHUAC- Complexo Hospitalario Universitario A Coruna- University of A Coruna, La Coruna, Spain.
⁶ Institute of Family Medicine, University of Szeged, Szeged, Hungary.
⁷ Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà, Curitiba, Brazil.
⁸ Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation.
⁹ Clinical Cardiology Department, Clinical Hospital Zvezdara, Medical School, University of Belgrade, Belgrade, Serbia.
¹⁰ Head of Cardiology Department, Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria.
¹¹ Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia.
¹² SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, Firenze, Italy.
¹³ Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
¹⁴ Cardiology Department, San Luca Hospital, Lucca, Italy.
¹⁵ Hospital de Clinicas de Porto Alegre - Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
¹⁶ Cardiology Division, Hospital San José, Criciuma, Brasil.
¹⁷ Hospital Sao Vicente de Paulo E Hospital de Cidade, Passo Fundo, Brasil.
¹⁸ Cardiology Department, Parma University Hospital, Parma, Italy.
¹⁹ Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, St Petersburg, Russian Federation.
²⁰ Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina.
²¹ Echocardiography Lab, Cardio-Thorax-Vascular Department, "Policlinico Vittorio Emanuele", Catania University, Catania, Italy.
²² Cardiology Department, Nocera Inferiore, Salerno, Italy.
²³ Cardiology Division, Ospedale San Camillo, Rome, Italy.
²⁴ Cardiology Division, Pediatric Cardiology Department, Brompton Hospital, Imperial College of London, London, UK.
²⁵ Department of Cardiology, Ospedale per gli Infermi, Faenza, Ravenna, Italy.
²⁶ Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
²⁷ Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy.
²⁸ Cardiovascular Imaging Unit, Monaldi Hospital, AORN Colli, Naples, Italy.
²⁹ Cardiology Department and Echocardiography Lab, University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno, Italy.
³⁰ Italian Society of Echocardiography and Cardiovascular Imaging, Rome, Italy.
³¹ Cardiology Hospital, Policlinico University Hospital of Bari, Bari, Italy.
³² Cardiac Prevention and Rehabilitation Unit, Highly Specialized Rehabilitation Hospital Motta Di Livenza, Treviso, Italy.
³³ Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy. picano@ifc.cnr.it.

PMID: 33057991
DOI: 10.1007/s10554-020-02071-5

Multicenter Study

Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes

Doralisa Morrone et al. Int J Cardiovasc Imaging. 2021 Mar.

. 2021 Mar;37(3):953-964.

doi: 10.1007/s10554-020-02071-5. Epub 2020 Oct 15.

Authors

Affiliations

¹ Cardiothoracic Department, University of Pisa, Pisa, Italy.
² Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina.
³ Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland.
⁴ Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy.
⁵ CHUAC- Complexo Hospitalario Universitario A Coruna- University of A Coruna, La Coruna, Spain.
⁶ Institute of Family Medicine, University of Szeged, Szeged, Hungary.
⁷ Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà, Curitiba, Brazil.
⁸ Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation.
⁹ Clinical Cardiology Department, Clinical Hospital Zvezdara, Medical School, University of Belgrade, Belgrade, Serbia.
¹⁰ Head of Cardiology Department, Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria.
¹¹ Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia.
¹² SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, Firenze, Italy.
¹³ Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico.
¹⁴ Cardiology Department, San Luca Hospital, Lucca, Italy.
¹⁵ Hospital de Clinicas de Porto Alegre - Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil.
¹⁶ Cardiology Division, Hospital San José, Criciuma, Brasil.
¹⁷ Hospital Sao Vicente de Paulo E Hospital de Cidade, Passo Fundo, Brasil.
¹⁸ Cardiology Department, Parma University Hospital, Parma, Italy.
¹⁹ Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, St Petersburg, Russian Federation.
²⁰ Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina.
²¹ Echocardiography Lab, Cardio-Thorax-Vascular Department, "Policlinico Vittorio Emanuele", Catania University, Catania, Italy.
²² Cardiology Department, Nocera Inferiore, Salerno, Italy.
²³ Cardiology Division, Ospedale San Camillo, Rome, Italy.
²⁴ Cardiology Division, Pediatric Cardiology Department, Brompton Hospital, Imperial College of London, London, UK.
²⁵ Department of Cardiology, Ospedale per gli Infermi, Faenza, Ravenna, Italy.
²⁶ Institute of Management, Scuola Superiore Sant'Anna, Pisa, Italy.
²⁷ Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy.
²⁸ Cardiovascular Imaging Unit, Monaldi Hospital, AORN Colli, Naples, Italy.
²⁹ Cardiology Department and Echocardiography Lab, University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno, Italy.
³⁰ Italian Society of Echocardiography and Cardiovascular Imaging, Rome, Italy.
³¹ Cardiology Hospital, Policlinico University Hospital of Bari, Bari, Italy.
³² Cardiac Prevention and Rehabilitation Unit, Highly Specialized Rehabilitation Hospital Motta Di Livenza, Treviso, Italy.
³³ Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy. picano@ifc.cnr.it.

PMID: 33057991
DOI: 10.1007/s10554-020-02071-5

Abstract

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 ± 12 years) 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 ≥ 6.8 ml/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.

Keywords: Dipyridamole; Dobutamine; Echocardiography; Exercise; Left atrial volume; Stress.

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References

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Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes

Affiliations

Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes

Authors

Affiliations

Abstract

References

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LinkOut - more resources

Full Text Sources