Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary s
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ORIGINAL PAPER
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 Citro29,30 · Paolo Colonna30,31 · Bruno Villari4 · Francesco Antonini‑Canterin30,32 · Clara Carpeggiani27 · Jorge Lowenstein2 · Eugenio Picano27 on behalf of The Stress Echo 2020 study group of the Italian Society of Echocardiography and Cardiovascular Imaging - Subproject all you need is LAV Received: 27 August 2020 / Accepted: 9 October 2020 © Springer Nature B.V. 2020
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 rest), when at least two adjacent segments of the same vascular territory of the left ventricle showed an increment of at least one point of WMS during SE. The B criterion was considered positive in presence of stress or rest B-lines ≥ 2 units. The C criterion was considered positive in presence of force-based LVCR ≤ 2.0 for exercise and dobutamine (≤ 1.1 for vasodilators). The D criterion was considered positive in presence of CFVR ≤ 2.0. The E criterion was considered positive in presence of HRR 0.90. The LA images were selected to represent the wide variety of stress testing modes, responses, results and image quality. They came from quality controlled laboratories in four countries (Bulgaria-Sofia, Italy Pisa-Cisanello,
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