Scali, Maria Chiara (55929478400)Maria Chiara (55929478400)ScaliZagatina, Angela (22939399700)Angela (22939399700)ZagatinaCiampi, Quirino (6602299243)Quirino (6602299243)CiampiCortigiani, Lauro (55663049600)Lauro (55663049600)CortigianiD'Andrea, Antonello (55612687400)Antonello (55612687400)D'AndreaDaros, Clarissa Borguezan (57192979152)Clarissa Borguezan (57192979152)DarosZhuravskaya, Nadezhda (22939707600)Nadezhda (22939707600)ZhuravskayaKasprzak, Jaroslaw D. (35452933600)Jaroslaw D. (35452933600)KasprzakWierzbowska-Drabik, Karina (12772110800)Karina (12772110800)Wierzbowska-DrabikLuis de Castro e Silva Pretto, José (57200859205)José (57200859205)Luis de Castro e Silva PrettoDjordjevic-Dikic, Ana (57003143600)Ana (57003143600)Djordjevic-DikicBeleslin, Branko (6701355424)Branko (6701355424)BeleslinPetrovic, Marija (57207720679)Marija (57207720679)PetrovicBoskovic, Nikola (6508290354)Nikola (6508290354)BoskovicTesic, Milorad (36197477200)Milorad (36197477200)TesicMonte, Ines (55884115100)Ines (55884115100)MonteSimova, Iana (23391267500)Iana (23391267500)SimovaVladova, Martina (57218480094)Martina (57218480094)VladovaBoshchenko, Alla (6602887127)Alla (6602887127)BoshchenkoVrublevsky, Alexander (6701757460)Alexander (6701757460)VrublevskyCitro, Rodolfo (15921921800)Rodolfo (15921921800)CitroAmor, Miguel (37066931100)Miguel (37066931100)AmorVargas Mieles, Paul E. (57218481743)Paul E. (57218481743)Vargas MielesArbucci, Rosina (57201675703)Rosina (57201675703)ArbucciMerlo, Pablo Martin (57191339958)Pablo Martin (57191339958)MerloLowenstein Haber, Diego M. (56112672500)Diego M. (56112672500)Lowenstein HaberDodi, Claudio (6602478787)Claudio (6602478787)DodiRigo, Fausto (6701803166)Fausto (6701803166)RigoGligorova, Suzana (11840443000)Suzana (11840443000)GligorovaDekleva, Milica (56194369000)Milica (56194369000)DeklevaSeverino, Sergio (7006690054)Sergio (7006690054)SeverinoLattanzi, Fabio (7005850087)Fabio (7005850087)LattanziMorrone, Doralisa (36478990700)Doralisa (36478990700)MorroneGalderisi, Maurizio (57203882101)Maurizio (57203882101)GalderisiTorres, Marco A.R. (7402581476)Marco A.R. (7402581476)TorresSalustri, Alessandro (36943779100)Alessandro (36943779100)SalustriRodrìguez-Zanella, Hugo (56109055800)Hugo (56109055800)Rodrìguez-ZanellaCostantino, Fabio Marco (55499164600)Fabio Marco (55499164600)CostantinoVarga, Albert (7102315827)Albert (7102315827)VargaAgoston, Gergely (55206815100)Gergely (55206815100)AgostonBossone, Eduardo (55238465000)Eduardo (55238465000)BossoneFerrara, Francesco (57201099810)Francesco (57201099810)FerraraGaibazzi, Nicola (6603190525)Nicola (6603190525)GaibazziCelutkiene, Jelena (6507133552)Jelena (6507133552)CelutkieneHaberka, Maciej (22834420800)Maciej (22834420800)HaberkaMori, Fabio (24290552500)Fabio (24290552500)MoriD'Alfonso, Maria Grazia (55959365300)Maria Grazia (55959365300)D'AlfonsoReisenhofer, Barbara (6603491191)Barbara (6603491191)ReisenhoferCamarozano, Ana Cristina (14055534600)Ana Cristina (14055534600)CamarozanoMiglioranza, Marcelo Haertel (35956952500)Marcelo Haertel (35956952500)MiglioranzaSzymczyk, Ewa (25121768000)Ewa (25121768000)SzymczykWejner-Mik, Paulina (6603038461)Paulina (6603038461)Wejner-MikWdowiak-Okrojek, Katarzyna (44261600800)Katarzyna (44261600800)Wdowiak-OkrojekPreradovic-Kovacevic, Tamara (59158416100)Tamara (59158416100)Preradovic-KovacevicBombardini, Tonino (6701802597)Tonino (6701802597)BombardiniOstojic, Miodrag (34572650500)Miodrag (34572650500)OstojicNikolic, Aleksandra (59432908700)Aleksandra (59432908700)NikolicRe, Federica (57210067725)Federica (57210067725)ReBarbieri, Andrea (56377673100)Andrea (56377673100)BarbieriDi Salvo, Giovanni (7003610825)Giovanni (7003610825)Di SalvoMerli, Elisa (6701858723)Elisa (6701858723)MerliColonna, Paolo (57221823607)Paolo (57221823607)ColonnaLorenzoni, Valentina (57964799700)Valentina (57964799700)LorenzoniDe Nes, Michele (6507042094)Michele (6507042094)De NesPaterni, Marco (7003660393)Marco (7003660393)PaterniCarpeggiani, Clara (7003751506)Clara (7003751506)CarpeggianiLowenstein, Jorge (7103408229)Jorge (7103408229)LowensteinPicano, Eugenio (7102408994)Eugenio (7102408994)Picano2025-06-122025-06-122020https://doi.org/10.1016/j.jcmg.2020.04.020https://www.scopus.com/inward/record.uri?eid=2-s2.0-85089290503&doi=10.1016%2fj.jcmg.2020.04.020&partnerID=40&md5=349cfd7dc263f10189f0446632058179https://remedy.med.bg.ac.rs/handle/123456789/4717Objectives: The purpose of this study was to assess the functional and prognostic correlates of B-lines during stress echocardiography (SE). Background: B-profile detected by lung ultrasound (LUS) is a sign of pulmonary congestion during SE. Methods: The authors prospectively performed transthoracic echocardiography (TTE) and LUS in 2,145 patients referred for exercise (n = 1,012), vasodilator (n = 1,054), or dobutamine (n = 79) SE in 11 certified centers. B-lines were evaluated in a 4-site simplified scan (each site scored from 0: A-lines to 10: white lung for coalescing B-lines). During stress the following were also analyzed: stress-induced new regional wall motion abnormalities in 2 contiguous segments; reduced left ventricular contractile reserve (peak/rest based on force, ≤2.0 for exercise and dobutamine, ≤1.1 for vasodilators); and abnormal coronary flow velocity reserve ≤2.0, assessed by pulsed-wave Doppler sampling in left anterior descending coronary artery and abnormal heart rate reserve (peak/rest heart rate) ≤1.80 for exercise and dobutamine (≤1.22 for vasodilators). All patients completed follow-up. Results: According to B-lines at peak stress patients were divided into 4 different groups: group I, absence of stress B-lines (score: 0 to 1; n = 1,389; 64.7%); group II, mild B-lines (score: 2 to 4; n = 428; 20%); group III, moderate B-lines (score: 5 to 9; n = 209; 9.7%) and group IV, severe B-lines (score: ≥10; n = 119; 5.4%). During median follow-up of 15.2 months (interquartile range: 12 to 20 months) there were 38 deaths and 28 nonfatal myocardial infarctions in 64 patients. At multivariable analysis, severe stress B-lines (hazard ratio [HR]: 3.544; 95% confidence interval [CI]: 1.466 to 8.687; p = 0.006), abnormal heart rate reserve (HR: 2.276; 95% CI: 1.215 to 4.262; p = 0.010), abnormal coronary flow velocity reserve (HR: 2.178; 95% CI: 1.059 to 4.479; p = 0.034), and age (HR: 1.031; 95% CI: 1.002 to 1.062; p = 0.037) were independent predictors of death and nonfatal myocardial infarction. Conclusions: Severe stress B-lines predict death and nonfatal myocardial infarction. (Stress Echo 2020–The International Stress Echo Study [SE2020]; NCT03049995) © 2020 American College of Cardiology Foundationcoronary artery diseaseheart failurelung ultrasoundstress echocardiography