The Palma Echo Platform: Rationale and Design of an Echocardiography Core Lab

Abstract

BackgroundThe metabolic syndrome (MetS) is associated with increased cardiovascular morbidity and mortality. Characterization of cardiac structural and functional abnormalities due to the MetS can help recognize individuals who would benefit the most from preventive interventions. Transthoracic echocardiography (TTE) provides an opportunity to identify those abnormalities in a reproducible and cost-efficient manner. In research settings, implementation of protocols for the acquisition and analysis of TTE images are key to ensure validity and reproducibility, thus facilitating answering relevant questions about the association of the MetS with cardiac alterations.Methods and ResultsThe Palma Echo Platform (PEP) is a coordinated network that is built up to evaluate the underlying structural and functional cardiac substrate of participants with MetS. Repeated TTE will be used to evaluate 5-year changes in the cardiac structure and function in a group of 565 individuals participating in a randomized trial of a lifestyle intervention for the primary prevention of cardiovascular disease. The echocardiographic studies will be performed at three study sites, and will be centrally evaluated at the PEP core laboratory. Planned analyses will involve evaluating the effect of the lifestyle intervention on cardiac structure and function, and the association of the MetS and its components with changes in cardiac structure and function. Particular emphasis will be placed on evaluating parameters of left atrial structure and function, which have received more limited attention in past investigations. This PEP will be available for future studies addressing comparable questions.ConclusionIn this article we describe the protocol of a central echocardiography laboratory for the study of functional and structural alterations of the MetS.

Effect of an intensive lifestyle intervention on circulating biomarkers of atrial fibrillation-related pathways

“…As part of an ancillary study to the PREDIMED-Plus trial, echocardiographic studies were conducted in 3 PREDIMED-Plus study sites (University of Navarra, Araba University Hospital, Son Espases University Hospital; n = 566), and blood biomarkers were measured at baseline and years 3 and 5 after randomization in a sub-sample of those who had echocardiographic assessment. 28…”

“…As part of an ancillary study to the PREDIMED-Plus trial, echocardiographic studies were conducted in 3 PREDIMED-Plus study sites (University of Navarra, Araba University Hospital, Son Espases University Hospital; n = 566), and blood biomarkers were measured at baseline and years 3 and 5 after randomization in a sub-sample of those who had echocardiographic assessment. 28 For this analysis, participants who completed baseline and at least one follow-up exam were included; subjects who had AF at baseline and lacked blood biomarker measurements at baseline and at both the year 3 and year 5 follow-up visits were excluded from this study (Figure 1). Institutional Review Boards at all participating institutions approved the study.…”

Effect of an intensive lifestyle intervention on the structural and functional substrate for atrial fibrillation in people with metabolic syndrome

“…Images were then transferred to a core lab for their assessment. 12 The rationale and design of the corelab Palma Echo Platform (PEP) has been published elsewhere. 12 .…”

“…12 The rationale and design of the corelab Palma Echo Platform (PEP) has been published elsewhere. 12 .…”

“…15 TTEs were performed at each site at baseline, 3-year and 5-year follow-up following a standardized protocol. 12 Images were obtained at each centre by cardiologists with expertise in cardiac imaging, but they were assessed in a blind fashion by two independent expert cardiologists (core lab evaluators) not involved in obtaining the images. Each cardiologist was responsible for assessing a set of outcomes, so that each echocardiographic measure was assessed by one single cardiologist through the entire follow-up.…”