The prognostic value of positive stress echocardiography and its relationship with invasive coronary angiography: Rationale and design of the multicenter stress echo trial – AMPHIPOLIS

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Problems in Cardiology Pub Date : 2025-05-15 DOI:10.1016/j.cpcardiol.2025.103075

Nikolaos PE Kadoglou , Constantinos H. Papadopoulos , Vasilios Sahpekidis , Konstantinos G. Papadopoulos , Nearchos Kassinos , Anastasios Theodosis-Georgilas

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引用次数: 0

Abstract

Introduction/aim: Stress echocardiography (SE) is a first-line, non-invasive and well-validated technique for the diagnosis and decision making of coronary artery disease (CAD). The introduction of echocardiographic contrast agents, the growing usage of exercise on supine bike as a stressor and the recent technological advances have considerably improved the sensitivity of SE. Despite those advantages, SE remains an operator-dependent technique, and its association with CAD prognosis is based on limited evidence from old studies. Our aim is a) to assess the positive prognostic value of SE in patients with established or suspected CAD and b) to evaluate the relationship between SE findings and invasive coronary angiography (ICA) findings.

Methods: We describe the rationale and design of Amphipolis trial, a prospective, multicentre, self-controlled, open-label trial from 22 labs in Greece and Cyprus. We plan to enrol 390 consecutive adults with a positive SE based on echocardiographic findings, fulfilling specific selection criteria. All participants will undergo ICA within 6 weeks from positive SE. Then, we will be followed up them for at least 12 months for major adverse cardiovascular events (MACE) such as cardiovascular death, acute coronary syndrome (ACS), revascularization interventions (re-stenosis or new cases of myocardial ischemia), or the development of symptoms (angina relapse or new onset).

Conclusions: Amphipolis trial will test the prognostic role of SE, and its implementation in clinical practice along with anatomical findings from ICA.

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正性应激超声心动图的预后价值及其与有创冠状动脉造影的关系：多中心应激超声试验的原理和设计- AMPHIPOLIS。

简介/目的：应激超声心动图（SE）是一种用于冠状动脉疾病（CAD）诊断和决策的一线、无创和成熟的技术。超声心动图造影剂的引入，仰卧自行车运动作为应激源的使用越来越多，以及最近的技术进步大大提高了SE的敏感性。尽管有这些优势，SE仍然是一种依赖于操作者的技术，其与CAD预后的关联是基于旧研究的有限证据。我们的目的是a)评估SE在确诊或疑似CAD患者中的预后价值，b)评估SE表现与有创冠状动脉造影（ICA）表现之间的关系。方法：我们描述了Amphipolis试验的基本原理和设计，这是一项来自希腊和塞浦路斯22个实验室的前瞻性、多中心、自我控制、开放标签试验。我们计划根据超声心动图结果连续招募390名SE阳性的成年人，满足特定的选择标准。所有参与者在SE阳性后6周内接受ICA治疗。然后，我们将对他们进行至少12个月的主要心血管不良事件（MACE）随访，如心血管性死亡、急性冠状动脉综合征（ACS）、血运重建干预（再狭窄或新的心肌缺血病例）或症状的发展（心绞痛复发或新发）。结论：Amphipolis试验将测试SE的预后作用，并将其应用于临床实践以及ICA的解剖结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Problems in Cardiology 医学-心血管系统

CiteScore

4.80

自引率

2.40%

发文量

392

审稿时长

6 days

期刊介绍： Under the editorial leadership of noted cardiologist Dr. Hector O. Ventura, Current Problems in Cardiology provides focused, comprehensive coverage of important clinical topics in cardiology. Each monthly issues, addresses a selected clinical problem or condition, including pathophysiology, invasive and noninvasive diagnosis, drug therapy, surgical management, and rehabilitation; or explores the clinical applications of a diagnostic modality or a particular category of drugs. Critical commentary from the distinguished editorial board accompanies each monograph, providing readers with additional insights. An extensive bibliography in each issue saves hours of library research.