Ejection fraction, B-lines, and global longitudinal strain evaluated with rest transthoracic echocardiography to assess prognosis in patients with chronic coronary syndromes

Author:

Cortigiani Lauro1ORCID,Orsino Maria Francesca1,Favilli Marco1,Bovenzi Francesco1

Affiliation:

1. UO Malattie Cardiovascolari, Ospedale San Luca, 55100 Lucca, Italy

Abstract

Aim: Transthoracic echocardiography (TTE) is the first-line imaging test for patients with chronic coronary syndrome (CCS) and the cornerstone of risk stratification is left ventricular (LV) ejection fraction (EF). Aim of the study was to investigate the value of TTE supplemented with strain echocardiography (STE) and lung ultrasound (LUS) to assess the risk of patients with CCS. Methods: In a prospective, single-center, observational study, from November 2020 to December 2022, 529 consecutive patients with CCS were recruited. All patients were evaluated at rest. A single vendor machine (GE Vivid E95) was used. EF with biplane Simpson’s method (abnormal cut-off < 50%), LV global longitudinal strain (GLS%, abnormal cut-off ≤ 16.2% by receiver-operating characteristics analysis) by STE, and B-line score (abnormal cut-off ≥ 2) by LUS (4-site simplified scan) were assessed. Integrated TTE score ranged from 0 (all 3 parameters normal) to 3 (all parameters abnormal). All patients were followed-up and a composite endpoint was considered, including all-cause death, acute coronary syndrome (ACS), and myocardial revascularization. Results: During a follow-up of 14.2 months ± 8.3 months, 72 events occurred: 10 deaths, 11 ACSs, and 51 myocardial revascularizations. In multivariable analysis, B lines [hazard ratio (HR) 1.76, 95% confidence Interval (CI) 1.05–2.97; P = 0.03], and GLS ≤ 16.2% (HR 2.0, 95% CI 1.17–3.45; P = 0.01) were independent predictors of events. EF < 50% was a significant predictor in univariate, but not in multivariable analysis. Event rate at 2 years increased from score 0 (8%), to score 1 (21%), 2 (23%), and 3 (40%), P < 0.0001. Conclusions: TTE with left ventricular ejection fraction (LVEF) can be usefully integrated with STE for GLS, and LUS for B-lines, for better prediction of outcome in CCS. The 3 parameters can be obtained in every echo lab with basic technology, no harm, no risk, and no stress.

Publisher

Open Exploration Publishing

Subject

Horticulture,Plant Science,Soil Science,Agronomy and Crop Science,Computer Science Applications,Sociology and Political Science,Anthropology,Cultural Studies,Applied Mathematics,Geometry and Topology,Analysis,Animal Science and Zoology,Ecology,Ecology, Evolution, Behavior and Systematics

Reference30 articles.

1. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C, et al.; ESC Scientific Document Group. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes: the Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Eur Heart J. 2020;41:407–77.

2. Gulati M, Levy PD, Mukherjee D, Amsterdam E, Bhatt DL, Birtcher KK, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. J Am Coll Cardiol. 2021;78:e187–285.

3. Authors/Task Force Members:, McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al.; ESC Scientific Document Group. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. 2022;24:4–131.

4. Edvardsen T, Asch FM, Davidson B, Delgado V, DeMaria A, Dilsizian V, et al. Non-invasive imaging in coronary syndromes: recommendations of the European Association of Cardiovascular Imaging and the American Society of Echocardiography, in collaboration with the American Society of Nuclear Cardiology, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. Eur Heart J Cardiovasc Imaging. 2022;23:e6–33.

5. Abou R, van der Bijl P, Bax JJ, Delgado V. Global longitudinal strain: clinical use and prognostic implications in contemporary practice. Heart. 2020;106:1438–44.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3