Picano Eugenio, Ciampi Quirino, Arbucci Rosina, Zagatina Angela, Kalinina Elena, Padang Ratnasari, Kane Garvan C, Villarraga Hector R, Arruda-Olson Adelaide M, Vazquez Jesus Peteiro, Boshchenko Alla, Zhuravleva Olga, Ryabova Tamara, Sviazova Natalia, Celutkiené Jelena, Balkevičienė Laura, Saad Ariel, Bursi Francesca, Djordjevic-Dikic Ana, Kobal Sergio, Lisi Matteo, Merli Elisa, Manganelli Fiore, Borguezan-Daros Clarissa, Rodriguez-Zanella Hugo, D'Alfonso Maria Grazia, Mori Fabio, Gaibazzi Nicola, Kasprzak Jaroslaw D, Safarova Ayten, Timofeeva Tatiana, Mosto Hugo, Wierzbowska-Drabik Karina, Ratanasit Nithima Chaowalit, Costantino Marco Fabio, Colonna Paolo, Preradović Tamara Kovačević, Ostojic Miodrag, Cortigiani Lauro, Varga Albert, Nikolic Aleksandra, Cocchia Rosangela, Palinkas Attila, Palinkas Eszter Dalma, Rigo Fausto, Benfari Giovanni, Valente Filipa Xavier, Soulis Dimitrios, Wang Yi, Yin Lixue, Van de Heyning Caroline M, Mazzi Alberto, Lowenstein Jorge, Haber Diego M Lowenstein, Marconi Sofia, Barbieri Andrea, Mantovani Francesca, Tripepi Giovanni L, De Nes Michele, Bartolacelli Ylenia, Villari Bruno, Pepi Mauro, Carerj Scipione, Pellikka Patricia A
Cardiology Clinic, University Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia.
Division of Cardiology, Fatebenefratelli Hospital, Benevento, Italy.
J Cardiovasc Echogr. 2025 Jan-Mar;35(1):1-7. doi: 10.4103/jcecho.jcecho_2_25. Epub 2025 Apr 30.
Over the past decade, stress echocardiography has evolved from a test for assessing epicardial artery stenosis to a comprehensive functional test, targeting multiple cardiovascular parameters. The new approach includes several structured steps: (a) evaluating regional wall motion abnormalities to detect epicardial artery stenosis or vasospasm; (b) assessing pulmonary congestion and diastolic function via B-lines with lung ultrasound; (c) gauging preload and contractile reserve with volumetric echocardiography; (d) measuring coronary microvascular reserve using Doppler-based coronary flow velocity in the middistal left anterior descending artery; and (e) determining cardiac sympathetic reserve by tracking heart rate reserve on an ECG. This evolution was supported extensively by the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI), which played a key role in five areas: (1) developing the initial, curiosity-driven project; (2) disseminating protocols and results at national and international conferences, supporting logistic infrastructure and publication expenses; (3) establishing a digital platform (customized Redcap) for data entry and storage; (4) facilitating patient recruitment across 19 Italian centers; and (5) offering formal endorsement through six presidencies, adding credibility and reach beyond any single institution. The protocol quickly advanced from concept to high-impact publications, earning inclusion in 2024 specialty guidelines. Initially Italian-led, the study now includes 50 centers across 20 countries (e.g. USA and China). Beyond the 50 peer-reviewed papers published in 2016-2024, this study offers a novel, sustainable approach to cardiac stress testing, providing more information at lower costs, with zero radiation and minimal environmental impact. SIECVI's endorsement was instrumental in amplifying the study's rigor and outreach.
在过去十年中，负荷超声心动图已从一项评估心外膜动脉狭窄的检查发展成为一项针对多个心血管参数的综合功能检查。新方法包括几个结构化步骤：(a) 评估节段性室壁运动异常以检测心外膜动脉狭窄或血管痉挛；(b) 通过肺部超声的B线评估肺淤血和舒张功能；(c) 用容积超声心动图测量前负荷和收缩储备；(d) 使用基于多普勒的左前降支中远段冠状动脉血流速度测量冠状动脉微血管储备；(e) 通过在心电图上追踪心率储备来确定心脏交感神经储备。意大利超声心动图和心血管成像学会（SIECVI）广泛支持了这一发展，该学会在五个方面发挥了关键作用：(1) 开展最初由好奇心驱动的项目；(2) 在国内和国际会议上传播方案和结果，支持后勤基础设施和出版费用；(3) 建立一个用于数据录入和存储的数字平台（定制的Redcap）；(4) 促进意大利19个中心的患者招募；(5) 通过六届主席提供正式认可，增加了可信度并扩大了影响力，超越了任何单一机构。该方案迅速从概念发展到具有高影响力的出版物，并被纳入2024年专业指南。该研究最初由意大利牵头，现在包括20个国家（如美国和中国）的50个中心。除了在2016 - 2024年发表的50篇同行评审论文外，这项研究提供了一种新颖、可持续的心脏负荷测试方法，以更低的成本提供更多信息，零辐射且对环境影响最小。SIECVI的认可有助于增强该研究的严谨性和影响力。
