{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:23:21Z","timestamp":1791919401628,"version":"4.3.4"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Lung ultrasound detects pulmonary congestion as B-lines at rest, and more frequently, during exercise stress echocardiography (ESE).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We performed ESE plus lung ultrasound (4-site simplified scan) in 4392 subjects referred for semi-supine bike ESE in 24 certified centers in 9 countries. B-line score ranged from 0 (normal) to 40 (severely abnormal). Five different populations were evaluated: control subjects (n=103); chronic coronary syndromes (n=3701); heart failure with reduced ejection fraction (n=395); heart failure with preserved ejection fraction (n=70); ischemic mitral regurgitation \u2265 moderate at rest (n=123). In a subset of 2478 patients, follow-up information was available.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              During ESE, B-lines increased in all study groups except controls. Age, hypertension, abnormal ejection fraction, peak wall motion score index, and abnormal heart rate reserve were associated with B-lines in multivariable regression analysis. Stress B lines (hazard ratio, 2.179 [95% CI, 1.015\u20134.680];\n              <jats:italic>P<\/jats:italic>\n              =0.046) and ejection fraction &lt;50% (hazard ratio, 2.942 [95% CI, 1.268\u20136.822];\n              <jats:italic>P<\/jats:italic>\n              =0.012) were independent predictors of all-cause death (n=29 after a median follow-up of 29 months).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>B-lines identify the pulmonary congestion phenotype at rest, and more frequently, during ESE in ischemic and heart failure patients. Stress B-lines may help to refine risk stratification in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT 03049995.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.121.013558","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T18:01:27Z","timestamp":1652810487000},"source":"Crossref","is-referenced-by-count":32,"title":["Pulmonary Congestion During Exercise Stress Echocardiography in Ischemic and Heart Failure Patients"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7689-1167","authenticated-orcid":true,"given":"Elisa","family":"Merli","sequence":"first","affiliation":[{"name":"Department of Cardiology, Ospedale per gli Infermi, Faenza, Italy (E.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quirino","family":"Ciampi","sequence":"additional","affiliation":[{"name":"Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy (Q.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Scali","sequence":"additional","affiliation":[{"name":"Cardiology Division, Campostaggia Hospital, Siena, Italy (M.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9085-4872","authenticated-orcid":true,"given":"Angela","family":"Zagatina","sequence":"additional","affiliation":[{"name":"Cardiology Department, Saint Petersburg State University Hospital, Saint Petersburg, Russian Federation (A.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6413-1964","authenticated-orcid":true,"given":"Pablo Martin","family":"Merlo","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina (P.M.M., R.A., J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosina","family":"Arbucci","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina (P.M.M., R.A., J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3843-9049","authenticated-orcid":true,"given":"Clarissa Borguezan","family":"Daros","sequence":"additional","affiliation":[{"name":"Cardiology Division, Hospital San Jos\u00e9, Criciuma, Brasil (B.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-2753","authenticated-orcid":true,"given":"Jos\u00e9 Luis","family":"de Castro e Silva Pretto","sequence":"additional","affiliation":[{"name":"Hospital Sao Vicente de Paulo e Hospital de Cidade, Passo Fundo, Brasil (J.L.d.C.e.S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2848-2289","authenticated-orcid":true,"given":"Miguel","family":"Amor","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina (M.A., M.F.S., H.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael F.","family":"Salam\u00e8","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina (M.A., M.F.S., H.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7460-1904","authenticated-orcid":true,"given":"Hugo","family":"Mosto","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina (M.A., M.F.S., H.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9667-6931","authenticated-orcid":true,"given":"Doralisa","family":"Morrone","sequence":"additional","affiliation":[{"name":"Cardiology Department, Cisanello University Hospital, Pisa, Italy (D.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Cardiology, Monaldi Hospital, Second University of Naples, and Nocera Inferiore, Italy (A.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Reisenhofer","sequence":"additional","affiliation":[{"name":"Cardiology Division, Pontedera Hospital, Pontedera, Italy (B.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0336-5593","authenticated-orcid":true,"given":"Hugo","family":"Rodriguez-Zanella","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico (H.R.-Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina","family":"Wierzbowska-Drabik","sequence":"additional","affiliation":[{"name":"Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland (K.W.-D., J.D.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5850-8187","authenticated-orcid":true,"given":"Jaroslaw D.","family":"Kasprzak","sequence":"additional","affiliation":[{"name":"Chair of Cardiology, Bieganski Hospital, Medical University, Lodz, Poland (K.W.-D., J.D.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gergely","family":"Agoston","sequence":"additional","affiliation":[{"name":"Institute of Family Medicine, University of Szeged, Hungary (G.A., A.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Varga","sequence":"additional","affiliation":[{"name":"Institute of Family Medicine, University of Szeged, Hungary (G.A., A.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Lowenstein","sequence":"additional","affiliation":[{"name":"Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina (P.M.M., R.A., J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Dodi","sequence":"additional","affiliation":[{"name":"Cardiology Department, Ospedale di Cremona, Italy (C.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauro","family":"Cortigiani","sequence":"additional","affiliation":[{"name":"Cardiology Department, San Luca Hospital, Lucca, Italy (L.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3458-3684","authenticated-orcid":true,"given":"Iana","family":"Simova","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart and Brain Center of Excellence, University Hospital, Pleven, Bulgaria (I.S., M.S.)."},{"name":"Medical University, Pleven, Bulgaria (I.S., M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Samardjieva","sequence":"additional","affiliation":[{"name":"Cardiology Department, Heart and Brain Center of Excellence, University Hospital, Pleven, Bulgaria (I.S., M.S.)."},{"name":"Medical University, Pleven, Bulgaria (I.S., 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