Stress Echo Comprehensive Software (SECS) for State-of-the-art ABCDE Protocol

Marco Paterni, Clara Carpeggiani, Chirino Ciampi, Rodolfo Citro, Francesco Antonini-Canterin, Paolo Colonna, Eugenio Picano

Abstract


Background: Several specialized softwares are commercially available for the elective storage of stress echo (SE) data. Stateof-the-art SE is based upon novel parameters in addition to regional wall motion.Objective: To develop a novel software for SE data storage and reporting.Methods: We developed the prototype of a SE Comprehensive Software (SECS) with a minimum data set eventually allowingstandardized collection of data. The software runs with medium-low performance computers as well as with the most popularoperating systems (Windows, MAC OS and Linux). The export functions towards widely accepted formats allow easy data sharing.The software is able to generate a customized report which can be expanded in PDF and comma-separated value formats.Results: The program prototype data entry requires <2 min per study. The main pages focus on the 5 steps of ABCDE-SE: stepA (regional wall motion); step B (B-lines with 4-site simplified scan); step C (contractile reserve with force derived from systolicblood pressure and end-systolic volume); step D (Doppler-based coronary flow velocity reserve in left anterior descendingcoronary artery); step E (EKG-based chronotropic reserve measured as peak/rest heart rate). The final page graphically summarizesthe ABCDE information in a risk prediction model (cardiac death rate per year, from low risk <1% to high risk >3 %).Conclusion: SECS may provide a suitable infrastructure for an advanced clinical and research application, with simple graphicformat and convenient reporting option. It may represent a trade-off between exhaustive information required by scientificstandards and smooth workflow priority of busy, high volume, clinically-driven activities. Large scale validation and adaptationfrom users’ feedback is necessary prior to dissemination on demand.

References


Greenberg N. Update on current concepts and meanings in laboratory medicine --Standardization, traceability and harmonization. Clin Chim Acta 2014;432:49-54. http://doi.org/f59k8m

Pellikka PA, Arruda-Olson A, Chaudhry FA, Chen MH, Marshall JE, Porter TR, et al. Guidelines for Performance, Interpretation, and Application of Stress Echocardiography in Ischemic Heart Disease: From the American Society of Echocardiography 2019. J Am Soc Echocardiogr 2019;S0894-

(19)30825-9. http://doi.org/dhm3

Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, et al; European Association of Echocardiography Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC).Eur J Echocardiogr 2008;9:415-37. http://doi.org/dvxvq8

Picano E. Stress echocardiography: from pathophysiological toy to diagnostic tool. Point of view. Circulation 1992;85:1604-12. http://doi.org/bkgp

Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, Funck-Brentano C. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 2019; Eur Heart J 2019.pii: ehz425.

Picano E, Pellikka PA Stress echo applications beyond coronary artery disease. Eur Heart J. 2014;35:1033-40. http://doi.org/bkgr

Lancellotti P, Pellikka PA, Budts W, Chaudry F, Donal E, Dulgheru R, et al. The Clinical Use of Stress Echocardiography in Non-Ischaemic Heart Disease: Recommendations from the European Association of Cardiovascular Imaging and the American Society of Echocardiography. J Am Soc Echocardiogr 2017;30:101-38. http://doi.org/dfjt

Picano E, Ciampi Q, Wierzbowska-Drabik K, Urluescu ML, Morrone D, Carpeggiani C. The new clinical standard of integrated quadruple stress echocardiography with ABCD protocol. Cardiov Ultrasound 2018;16:22. http://doi.org/cv9d

Picano E, Scali MC. Stress echo, carotid arteries and more: Its versatility for our imaging times. JACC Cardiovasc Imaging 2018;11:181-3. http://doi.org/dfjv

Cortigiani L, Urluescu M, Coltelli M, Carpeggiani C, Bovenzi F, Picano E. Apparent declining prognostic value of a negative stress echocardiography based on regional wall motion abnormalities in patients with normal resting left ventricular function due to the changing referral profile of the population under study. Circulation Cardiov Imaging 2019; 12:e008564. http://doi.org/dfjw

Picano E, Pellikka PA. Ultrasound of extravascular lung water: a new standard for pulmonary congestion. Eur Heart J 2016;14:2091-104. http://doi.org/f8wbv4

Picano E, Scali MC, Ciampi Q, Lichtenstein D. Lung ultrasound for the cardiologist. JACC CV Imaging 2018;12:381-90. http://doi.org/dfjx

Scali MC, Zagatina A, Simova I, Zhuravskaya N, Ciampi Q, Paterni M et al. B-lines with Lung Ultrasound: The Optimal Scan Technique at Rest and During Stress . Ultrasound Med Biol 2017;43:2558-66.http://doi.org/gck4z8

Scali MC, Cortigiani L, Simionuc A, Gregori D, Marzilli M, Picano E Exercise-induced B-lines identify worse functional and prognostic stage in heart failure patients with depressed left ventricular function. Eur J Heart Fail 2017;19:1468-78. http://doi.org/f9qch4

Scali MC, Zagatina A, Ciampi Q, Cortigiani L, D’Andrea A,

Djordjevic-Dikic A. The functional meaning of B-profile during

Stress Lung ultrasound. JACC Cardiovasc Imaging2019;12:928-30.http://doi.org/dfjz

Bombardini T, Gherardi S, Arpesella G, Maccherini M, Serra W, Magnani G et al. Favorable short-term outcome of transplanted hearts selected from marginal donors by pharmacological stress echocardiography.

J Am Soc Echocardiogr 2011;24:353-62. http://doi.org/b2bbcw

Cortigiani L, Huqi A, Ciampi Q, Bombardini T, Bovenzi F, Picano E, et al. Integration of Wall Motion, Coronary Flow Velocity, and Left Ventricular Contractile Reserve in a Single Test: Prognostic Value of Vasodilator Stress Echocardiography in Patients with Diabetes. J Am Soc Echocardiogr 2018;31:692-701. http://doi.org/gdpq83

Lowenstein J, Tiano C, Marquez G, Presti C, Quiroz C. Simultaneous analysis of wall motion and coronary flow reserve of theleft anterior descending coronary artery by transthoracic Doppler echocardiography during dipyridamole stress. J Am Soc Echocardiogr 2003;16:607-13. http://doi.org/d2g25c

Lowenstein J. The assessment of coronary flow reserve should be an integral part of stress echo. Agonist. Rev Argent Cardiol 2010;7:432-5.

Lowenstein JA, Caniggia C, Rousse G, Amor M, Sánchez ME, Alasia D, et al. Coronary flow velocity reserve during pharmacologic stress echocardiography with normal contractility adds important prognostic value in diabetic and nondiabetic patients. J Am SocEchocardiogr 2014;27:1113-9. http://doi.org/bkgj

Ciampi Q, Zagatina A, Cortigiani L, Gaibazzi N, Borguezan

Daros C , Zhuravskaya N, et al. Functional, Coronary Anatomic

and Prognostic Correlates of Coronary Flow Velocity Reserve during Stress Echocardiography. J Am Coll Cardiol 2019; 74:2280-93. http://doi.org/dfj2

Cortigiani L, Carpeggiani C, Landi P, Raciti M, Bovenzi F, Picano E. Usefulness of blunted heart rate reserve as an imaging-independent prognostic predictor during dipyridamole-echocardiography test. AmJ Cardiol 2019;124:972-7. http://doi.org/dfj3

Picano E, Ciampi Q, Citro R, D’Andrea A, Scali MC, Cortigiani L, et al.Stress echo 2020: The international Stress Echo study in ischemic and non-ischemic heart disease. Cardiovasc Ultrasound 2017;15-3.

Pellikka PA, Douglas PS, Miller JG, Abraham TP, Baumann R, Buxton DB, et al. American Society of Echocardiography CardiovascularTechnology and Research Summit: a roadmap for 2020. J Am Soc Echocardiogr 2013;6:325-37. http://doi.org/bkgf

Carpeggiani C, Paterni M, Caramella D, Vano E, Semelka R,

Picano E, et al. A novel tool for user-friendly estimation of natural, diagnostic and professional radiation risk: Radio-Risk software. Eur J Radiol. 2012;81:3563-7. http://doi.org/dtvj48

Picano E, Vañó E, Rehani MM, Cuocolo A, Mont L, Bodi V, et al.The appropriate and justified use of medical radiation in cardiovascular imaging: a position document of the ESC Associations of Cardiovascular

Imaging, Percutaneous Cardiovascular Interventions and

Electrophysiology. Eur Heart J. 2014;35:665-72. http://doi.org/bkgq

2018 ACC/HRS/NASCI/SCAI/SCCT Expert Consensus Document on Optimal Use of Ionizing Radiation in Cardiovascular Imaging:Best Practices for Safety and Effectiveness: A Report of the American College of Cardiology Task Force on Expert Consensus DecisionPathways. J Am Coll Cardiol 2018;71:e283-e351.


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Revista argentina de cardiología. ISSN en línea 1850-3748. Argentine journal of cardiology (English ed. Online ISSN 2314-2286) Sociedad Argentina de Cardiología. Azcuénaga 980 (C1115AAD),Ciudad Autónoma de Buenos Aires, República Argentina. Tel. (54 11) 4961-6027/8/9 Fax: 4961-6020 www.sac.org.ar revista@sac.org.ar