ABCDE stress echocardiography parameters in predicting immediate cardiovascular events in patients with confirmed and suspected coronary artery disease

Aim. To assess the role of stress echocardiography (SE) parameters according to ABCDE protocol as predictors of cardiovascular events (CVD). Material and methods. This single-center prospective study included 253 patients (men n=130, 51,4%; median age, 62 (53; 68) years) with confirmed (14,2%) and suspected coronary artery disease (CAD). Exercise SE was performed according to clinical indications. The ABCDE protocol included assessment of regional wall motion (step A), B-lines (step B), contractile (step C), coronary (step D), chronotropic (step E) reserves of the left ventricle. The median follow-up period was 198 (118; 324) days. Twenty one (8,3%) patients underwent revascularization, while 11 patients (4,4%) were rehospitalized for cardiovascular events. The influence of clinical and echocardiographic parameters on endpoints was assessed. Results. The incidence of abnormal SE results was 8,7% (n=22) for step A, 10,7% (n=27) for step B, 63,6% (n=161) for step C, 47,4% n=120) for step D, and 35,6% (n=90) for step E. An independent predictor of readmission was the ACDE profile (a combination of positive SE steps) (odds ratio, OR 22,4; p=0,003); predictors of revascularization were the ABCDE score (OR 24,4; p=0,005), chest pain pattern (OR 7,2; p=0,005), DE profile (OR 762; p=0,003), chronotropic reserve (OR 437; p=0,019), number of risk factors (OR 7,7; p=0,009). Conclusion. ABCDE protocol SE allows for a comprehensive assessment of heart functional status, improves the diagnostic ability of stress test, and identifies predictors of cardiovascular disease in patients with suspected and confirmed CAD.