About the EVAREST study
Following a pilot study in Oxford (OxCardioFuse), the EVAREST study began recruiting in March 2015. Initially patients were recruited into the study from hospitals in the Thames Valley area, however over the years the EVAREST study has expanded to include hospitals throughout the UK. The current EVAREST research network not only covers a wide geographical area, but also contains a wide variety of hospital sizes and encompasses both high and low volume stress echocardiography departments. It therefore makes EVAREST uniquely placed to provide the first large scale insight into stress echocardiography practice in ‘real world’ NHS practice.
Currently, over 8000 patients have signed up to take part in the EVAREST study, making it one of the largest prospective studies into stress echocardiography in the world.
In September 2020, we began collaborating with the British Society of Echocardiography, who will be conducting a National Review of Stress Echocardiography Practice (BSE N-STEP) with the anonymized data from this study. For more details see or contact the team via e-mail: BSE.NSTEP@cardiov.ox.ac.uk or firstname.lastname@example.org.
Phases of the evarest study
The EVAREST study is comprised of three patient groups:
- Group 1: Investigating the utility of blood biomarkers to improve the accuracy of stress echocardiography (Recruitment completed: 2016)
- Group 2: Examining the performance, accuracy and cost of stress echocardiography in the identification of ischaemic heart disease. Investigating the use of imaging biomarkers to improve the accuracy of stress echocardiography. (Recruitment completed: March 2020).
- Group 3: Examining the use, performance and accuracy of all forms of stress echocardiography across the UK (Recruitment ongoing).
Why are we carrying out this study?
Stress echocardiography is a widely used, non-invasive imaging test used for detection of heart disease. It involves taking images of the heart using ultrasound under resting conditions and then repeating these images when the heart is beating faster (usually following a period of exercise on a treadmill or exercise bike, or through the infusion of a drug that increases the heart rate). This test is most commonly performed to assess whether the patient has significant coronary artery disease, however can be used to detect other forms of heart disease.
Stress echocardiography is known to be highly subjective and dependent on operator skill. Previous studies have reported that stress echocardiography has an accuracy of approximately 80% for the detection of coronary artery disease. We are therefore carrying out this study to determine the accuracy of stress echocardiography in everyday clinical practice in the NHS. We are also looking to examine how the test is performed, and whether this has any impact on accuracy, and also how patients are managed following their stress echocardiogram result.
We are also investigating whether biomarkers in blood samples (group 1 patients only), or from the stress echocardiogram images which predict outcome of patients (group 1 and 2 patients only), could be used to reduce variability of stress echocardiography and ensure consistent and accurate results.