ANZCTR - Registration

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Trial registered on ANZCTR

Registration number

ACTRN12617001387314

Ethics application status

Approved

Date submitted

4/09/2017

Date registered

29/09/2017

Date last updated

26/08/2019

Date data sharing statement initially provided

26/08/2019

Type of registration

Retrospectively registered

Titles & IDs

Public title

National Echocardiography Database Australia (NEDA). A longitudinal cohort study of echocardiograms from public and private echocardiography laboratories from around Australia, linked with the National Deaths Index.

Scientific title

National Echocardiography Database Australia (NEDA). A multicentre cohort longitudinal echocardiography study involving public and private echocardiography laboratories around Australia, assessing the prevalence and mortality of pulmonary hypertension and other cardiac abnormalities identified by echocardiography.

Secondary ID [1]

Nil Known

Universal Trial Number (UTN)

Trial acronym

NEDA

Linked study record

Health condition

Health condition(s) or problem(s) studied:

Cardiovascular Diseases

Pulmonary Hypertension

Condition category

Condition code

Cardiovascular

Other cardiovascular diseases

Cardiovascular

Normal development and function of the cardiovascular system

Respiratory

Other respiratory disorders / diseases

Intervention/exposure

Study type

Observational

Patient registry

False

Target follow-up duration

Target follow-up type

Description of intervention(s) / exposure

No intervention. Measurements and text interpretation information performed as part of a standard echo examination are collected from a backup copy of the echo database at each lab. The duration of the observation is from the first echo ever entered into the clinical database at the lab until the last echo entered when the backup database was taken. This time interval varies among each laboratory in Australia, and is dependent on when digital echocardiography was installed in the laboratory, and may be as long as 10 years. Since NEDA is a real world database, there is no intervention and no change to practice with NEDA.

Intervention code [1]

Not applicable

Comparator / control treatment

No control group

Control group

Uncontrolled

Outcomes

Primary outcome [1]

Prevalence of pulmonary hypertension, defined by elevated pulmonary artery systolic pressure (PASP) >40mmHg measured by echocardiography, in a diverse Australian population.

Timepoint [1]

The true prevalence in our echo cohort will be the proportion of patients with pulmonary hypertension in NEDA. The minimum indicative prevalence of pulmonary hypertension will be measured by the prevalence of pulmonary hypertension in our cohort of echocardiography patients projected against the Australian population. The time period for the observation will be those having echocardiography within the last 2 years and still alive at the time of the data analysis.

Primary outcome [2]

Prognosis of Pulmonary Hypertension as defined by Pulmonary Arterial Systolic Pressure (PASP) >= 40mmHg measured using echocardiography from within the NEDA cohort, matched against mortality, provided data linkage with the National Deaths Index.

Timepoint [2]

The time period for the observation will be those having echocardiography within the last 2 years and still alive at the time of the data analysis.

Secondary outcome [1]

The association between pulmonary artery systolic pressure and echo variables: left ventricular ejection fraction, mitral inflow E wave velocity, myocardial relaxation septal E’ velocity, E:E’ ratio, left atrial volume, right ventricular TAPSE, right ventricular basal and mid diameters, right ventricular Tei index, Noninvasive PVR estimation (Schiller equation), and right atrial volume.

Timepoint [1]

Each echo variable will be analysed against pulmonary artery systolic pressure using standard statistical analysis tools. The time period for the observation will be all echocardiograms in the NEDA database.

Secondary outcome [2]

Identification of additional echo parameters associated with markers of pulmonary hypertension disease severity and predictors of death. This is an exploratory analysis designed to identify those additional markers not identified as standard markers, and those not included in Secondary Outcome 1.

Timepoint [2]

The time period for the observation will be all echocardiograms in the NEDA database.

Secondary outcome [3]

Identification of reference ranges for echocardiographic variables. Reference intervals refer to the normal ranges normally found in healthy individuals. Since NEDA is a "big data" database, it is well suited to analysis of subgroups such as those without any demonstrable disease. Each individual measurement (up to 150 individual variables) will be subjected to this analysis. Only variables in which valid conclusions can be drawn based on the number of available measurements will be reported.

Timepoint [3]

The time period for the observation will be all echocardiograms in the NEDA database.

Eligibility

Key inclusion criteria

Participants will be considered those who have undergone echocardiography at one of the participating centres in accordance with standard clinical practice.

Minimum age

18 Years

Maximum age

No limit

Sex

Both males and females

Can healthy volunteers participate?

Key exclusion criteria

Individuals under the age of 18 will be excluded from the study and those who withdraw their consent. There are no other exclusion criteria for participants involved in the study. Individual data points may be excluded if a clause is present in an echo study suggesting that image quality was insufficient for accurate diagnostic imaging to be performed.

Study design

Purpose

Natural history

Duration

Longitudinal

Selection

Convenience sample

Timing

Both

Statistical methods / analysis

The planned sample size of 900,000 is based on 150 Australian
laboratories reporting an average of 3000 studies per year, with at least
one year of retrospective data available. This sample size will provide
good precision to estimate the prevalence of pulmonary hypertension, and the associated abnormalities of echocardiographic variables. Based on our previous data of an estimated median survival of 4.3+/-0.1 years for patients with all-cause pulmonary hypertension, a sample size of 779 PHT patients would be required to identify a characteristic associated with a 10% increase in risk, with power 80%, alpha level 0.05.
Since NEDA will have a vastly greater sample size than the necessary sample size for risk prediction described above, NEDA will be well powered to address the primary and secondary outcomes.

Recruitment

Recruitment status

Recruiting

Date of first participant enrolment

Anticipated

Actual

5/01/2015

Date of last participant enrolment

Anticipated

31/12/2020

Actual

Date of last data collection

Anticipated

31/12/2020

Actual

Sample size

Target

900000

Accrual to date

500000

Final

Recruitment in Australia

Recruitment state(s)

ACT,NSW,NT,QLD,SA,TAS,WA,VIC

Recruitment hospital [1]

Royal Prince Alfred Hospital - Camperdown

Recruitment hospital [2]

Nepean Hospital - Kingswood

Recruitment hospital [3]

Springwood Hospital - Springwood

Recruitment hospital [4]

Blue Mountains District ANZAC Memorial Hospital - Katoomba

Recruitment hospital [5]

Hawkesbury District Health Service - Windsor

Recruitment hospital [6]

John Hunter Hospital - New Lambton

Recruitment hospital [7]

St Vincent's Private Hospital (Darlinghurst) - Darlinghurst

Recruitment hospital [8]

Royal Darwin Hospital - Tiwi

Recruitment hospital [9]

Royal Hobart Hospital - Hobart

Recruitment hospital [10]

Sunshine Hospital - St Albans

Recruitment hospital [11]

Footscray Hospital - Footscray

Recruitment hospital [12]

Royal Perth Hospital - Perth

Recruitment hospital [13]

Fiona Stanley Hospital - Murdoch

Recruitment hospital [14]

Belmont Hospital - Belmont

Recruitment hospital [15]

The Maitland Hospital - Maitland

Recruitment hospital [16]

Barwon Health - Geelong Hospital campus - Geelong

Recruitment hospital [17]

The Prince Charles Hospital - Chermside

Recruitment hospital [18]

Blacktown Hospital - Blacktown

Recruitment hospital [19]

Baker Heart and Diabetes Institute - Melbourne

Recruitment hospital [20]

St Vincent's Hospital (Melbourne) Ltd - Fitzroy

Recruitment hospital [21]

Westmead Hospital - Westmead

Recruitment postcode(s) [1]

2050 - Camperdown

Recruitment postcode(s) [2]

2747 - Kingswood

Recruitment postcode(s) [3]

2777 - Springwood

Recruitment postcode(s) [4]

2780 - Katoomba

Recruitment postcode(s) [5]

2756 - Windsor

Recruitment postcode(s) [6]

2305 - New Lambton

Recruitment postcode(s) [7]

2010 - Darlinghurst

Recruitment postcode(s) [8]

0810 - Tiwi

Recruitment postcode(s) [9]

7000 - Hobart

Recruitment postcode(s) [10]

3021 - St Albans

Recruitment postcode(s) [11]

3011 - Footscray

Recruitment postcode(s) [12]

6000 - Perth

Recruitment postcode(s) [13]

6150 - Murdoch

Recruitment postcode(s) [14]

2280 - Belmont

Recruitment postcode(s) [15]

2320 - Maitland

Recruitment postcode(s) [16]

3220 - Geelong

Recruitment postcode(s) [17]

4032 - Chermside

Recruitment postcode(s) [18]

2148 - Blacktown

Recruitment postcode(s) [19]

3004 - Melbourne

Recruitment postcode(s) [20]

3065 - Fitzroy

Recruitment postcode(s) [21]

2145 - Westmead

Funding & Sponsors

Funding source category [1]

Commercial sector/Industry

Name [1]

Glaxo Smith-Kleine Pharmaceuticals

Address [1]

1061 Mountain Highway, Boronia Victoria 3155

Country [1]

Australia

Funding source category [2]

Commercial sector/Industry

Name [2]

Actelion Pharmaceuticals

Address [2]

Ste 6/ 13B Narabang Way, Belrose New South Wales 2085

Country [2]

Australia

Funding source category [3]

Commercial sector/Industry

Name [3]

Bayer Pharmaceuticals

Address [3]

875 Pacific Highway, Pymble New South Wales 2073

Country [3]

Australia

Primary sponsor type

Charities/Societies/Foundations

Name

NEDA Limited

Address

Unit 41, Mount Medical Centre
146 Mounts Bay Road
Perth WA 6000

Country

Australia

Secondary sponsor category [1]

None

Name [1]

Address [1]

Country [1]

Ethics approval

Ethics application status

Approved

Ethics committee name [1]

University of Notre Dame

Ethics committee address [1]

PO Box 1225
Fremantle, Western Australia 6959

Ethics committee country [1]

Australia

Date submitted for ethics approval [1]

18/08/2014

Approval date [1]

13/10/2014

Ethics approval number [1]

Ethics committee name [2]

Sydney Local Health District HREC

Ethics committee address [2]

Royal Prince Alfred Hospital
Camperdown NSW 2050

Ethics committee country [2]

Australia

Date submitted for ethics approval [2]

27/10/2015

Approval date [2]

16/03/2016

Ethics approval number [2]

Ethics committee name [3]

Australian Institute of Health and Welfare Ethics Committee

Ethics committee address [3]

GPO Box 570
Canberra ACT 2601

Ethics committee country [3]

Australia

Date submitted for ethics approval [3]

31/01/2016

Approval date [3]

03/06/2016

Ethics approval number [3]

Ethics committee name [4]

Tasmanian Health and Medical Research Ethics Committee

Ethics committee address [4]

University of Tasmania
Private Bag 1
Hobart TAS 7001

Ethics committee country [4]

Australia

Date submitted for ethics approval [4]

21/03/2016

Approval date [4]

08/06/2016

Ethics approval number [4]

Ethics committee name [5]

South Metropolitan Health Service HREC

Ethics committee address [5]

Level 2, Southern Research Facility (Perkins building)
Fiona Stanley Hospital, 11 Robin Warren Drive, MURDOCH WA 6150

Ethics committee country [5]

Australia

Date submitted for ethics approval [5]

03/05/2016

Approval date [5]

21/07/2016

Ethics approval number [5]

Ethics committee name [6]

Menzies School of Research HREC

Ethics committee address [6]

PO BOX 41096
Casuarina NT 0811

Ethics committee country [6]

Australia

Date submitted for ethics approval [6]

05/08/2016

Approval date [6]

14/11/2016

Ethics approval number [6]

Summary

Brief summary

Contemporary Australian data suggest that pulmonary hypertension (PHT) is more common than previously reported and confers a poor prognosis, however this single-centre data needs confirmation in a large population study from many locations and diverse backgrounds. Identification of underlying cause and prognosis of PHT non-invasively using simple markers would have a major impact on the diagnosis and management of patients with PHT.

PHT is often identified during echocardiography, performed for investigation of breathlessness. PHT is not a diagnosis in itself, but has a number of underlying causes that require additional investigation to delineate. Such causes include left heart diseases, various chronic respiratory illnesses, and chronic thromboembolic and pulmonary vascular diseases.

Over 900,000 echocardiograms (echos) are performed in Australia each year, but to date there has been no systematic method for capturing data from these echos. The newly developed National Echo Database Australia (NEDA) is designed to obtain measurement and report data, but no images, from digital echo laboratory across Australia and transfer them to a secure database, matched against national mortality data. The NEDA database will be the largest echo database in the world.  

Identification of the population of patients with PHT is of great importance, both to target those who may benefit from disease-specific therapy, and to better understand all forms of PHT in Australia and New Zealand. Abnormalities identifiable using echocardiography may be very useful prognostic indicators, and may help separate various causes for PHT. This information could be used to both identify patients who may respond to treatment, and to identify them earlier, with the goal of decreasing both morbidity and mortality for this common condition.

Trial website

www.neda.net.au

Trial related presentations / publications

Naing, P. et al., Performance of a Novel Echocardiographic Marker Against Right Heart Catheterisation in Identifying Pulmonary Hypertension due to Left Heart Disease, Heart, Lung and Circulation, 2017, Volume 26 (Supplement 2), S 269.

Chung, K; Playford, D; Celermajer, D; Codde, J; Scalia, G; Strange, G; Pulmonary hypertension due to diastolic dysfunction: a predictive model using the national echo database of Australia (NEDA), European Heart Journal, Volume 38, Issue suppl 1, 1 August 2017, P2590.

Playford et al. Making Australia the Benchmark in Echocardiography Databases: The National Echo Database Australia (NEDA). Pulmonary Circulation 2017;7(1):268.

Chung, K et al, The National Echo Database Australia (NEDA) and pulmonary hypertension, Pulmonary Circulation 2017;7(1):273.

Strange, G; Playford, D; Naing, P; Codde, J; Celermajer, D; Scalia, G, Chung, K; NEDA PH-LHD predictive model: validation of diastolic markers of pulmonary hypertension with right heart catheterisation, 6th World Symposium on Pulmonary Hypertension, Nice, France, February 27-28/March 1, 2018.

Strange, G; Playford, D; Codde, J; Celermajer, D; Scalia, G; Chung, K; Pulmonary Hypertension (PH) due to left heart disease: a predictive model using the national echo database of Australia (NEDA), , 6th World Symposium on Pulmonary Hypertension, Nice, France, February 27-28/March 1, 2018.

Chung, K. et al, NEDA PH-LHD predictive model: validation of diastolic markers of pulmonary hypertension with right heart catheterization, Pulmonary Circulation 2018; 8(2):1.

Chung, K. et al, Pulmonary hypertension due to left heart disease: a predictive model using the National Echo Database of Australia (NEDA), Pulmonary Circulation 2018; 8(2):5.

Playford, D; Bordin, E; Talbot, L; Mohamad, R; Anderson, B; Strange, G. Analysis of Aortic Stenosis using Artificial Intelligence, American Society of Echocardiography 28th Annual Scientific Sessions, 22-26 June 2018, Nashville USA. Journal of the American Society of Echocardiography, volume 31, B87.

Chung, K; Strange, G; Naing, P; Celermajer, D; Codde, J; Scalia, GM; Playford, D. Assessing the Cause of Pulmonary Hypertension on Echo in the Absence of Tricuspid Regurgitation – a NEDA (National Echo Database of Australia) Study. American Society of Echocardiography 28th Annual Scientific Sessions, 22-26 June 2018, Nashville USA. Journal of the American Society of Echocardiography, volume 31, B87.

Haghi, A; Stewart, S; Playford, D; Marwick, T; Celermajer, D; Prior, D; Scalia, G; Ilton, M; Strange, G.A Comparison of Long-Term Mortality Prediction Using Two Methods of EF Assessment from the National Echo Database Australia (NEDA) American Society of Echocardiography 28th Annual Scientific Sessions, 22-26 June 2018, Nashville USA. Journal of the American Society of Echocardiography, volume 31, B127.

Naing, P; Hillis, GS; Scalia, G; Strange, G; Codde, J; Playford, D. Differentiating Pre-Capillary and Post-Capillary Pulmonary Hypertension by Doppler Echocardiography in a Large Real-World Database, American Society of Echocardiography 28th Annual Scientific Sessions, 22-26 June 2018, Nashville USA. Journal of the American Society of Echocardiography, volume 31, B79.

Strange, G; Stewart, S; Celermajer, D; Marwick, T; Scalia, G; Prior, D; Ilton, M; Playford, D; Mortality from Aortic Stenosis Across the Spectrum of Severity: Analysis of Big Data from the National Echo Database of Australia (NEDA), American Society of Echocardiography 28th Annual Scientific Sessions, 22-26 June 2018, Nashville USA. Journal of the American Society of Echocardiography, volume 31, B52.

Strange, G; Stewart, S; Celermajer, D; Marwick, T; Scalia, G; Prior, D; Ilton, M; Playford, D; Mortality from Aortic Stenosis Across the Spectrum of Severity: Analysis of Big Data from the National Echo Database of Australia, Abstracts for the 65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting, 2018, Brisbane, Australia, Heart, Lung and Circulation, Volume 27, S256.

Murphy, C; Playford, D; Stewart, S; Celermajer, D; Marwick, T; Strange, G; Mortality from Left Atrial Enlargement Based on Method of Measurement: Analysis of Big Data from the National Echo Database of Australia, Abstracts for the 65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting, 2018, Brisbane, Australia, Heart, Lung and Circulation, Volume 27, S256.

Playford, D; Bordin, E; Talbot, L; Mohamed, R; Anderson, B; Strange, G; Analysis of Aortic Stenosis Using Artificial Intelligence, Abstracts for the 65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting, 2018, Brisbane, Australia, Heart, Lung and Circulation, Volume 27, S216.

Haghi, A; Stewart, S; Playford, D; Celermajer, D; Prior, D; Scalia, G; Ilton, M; Strange, G; Comparison of Long-Term Mortality Prediction Using Two Methods of Ejection Fraction Assessment from the National Echo Database Australia, Abstracts for the 65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting, 2018, Brisbane, Australia, Heart, Lung and Circulation, Volume 27, S208.

Chung, K; Strange, G; Naing, P; Codde, J; Celermajer, D; Scalia, G; Playford, D; Assessing the cause of pulmonary hypertension on echo in the absence of tricuspid regurgitation - A NEDA (National Echo Database of Australia) study, European Heart Journal, Volume 39, Issue suppl 1, 1 August 2018, P454.

Murphy, C; Playford, P; Stewart, S; Celermajer, D; Marwick, T; Strange, G; Mortality from left atrial enlargement based on method of measurement: analysis of big data from the national echo database of australia (NEDA), European Heart Journal, Volume 39, Issue suppl 1, 1 August 2018, 4133.

Playford, D; Mohamad, R; Talbot, L; Bordin, E; Strange, G; Artificial intelligence (AI) and echocardiography: a training model using real world data for imputation of missing measurements, European Heart Journal, Volume 39, Issue suppl 1, 1 August 2018, P5631.

Haghi, A; Stewart, S; Playford, D; Celermajer, D; Prior, D; Scalia, G; Ilton, M; G Strange; A comparison of long-term mortality prediction using two methods of EF assessment from the National Echo Database Australia (NEDA), European Heart Journal, Volume 39, Issue suppl 1, 1 August 2018, 6174.

Strange G, Celermajer DS, Marwick T, Prior D, Ilton M, Codde J, et al. The National Echocardiography Database Australia (NEDA): Rationale and methodology. American Heart Journal 2018; 

Strange G, Stewart S, Celermajer DS, Prior D, Scalia G, Marwick M, Gabbay E, Ilton M, Joseph M, Codde J and Playford D. Increased mortality associated with borderline pulmonary hypertenion: Insights from the National Echocardiography Database of Australia. 13th PVRI Annual World Congress on Pulmonary Vascular Disease, January 2019, Barcelona, Spain.

Strange G, Stewart S, Celermajer DS, Prior D, Scalia GM, Marwick TH, et al. Threshold of Pulmonary Hypertension Associated With Increased Mortality. J Am Coll Cardiol. 2019;73(21):2660–72.

Maron, B.A. and Wertheim B. M. Toward early diagnosis of Pulmonary Hypertension: Lessons from Oz, J Am Coll Cardiol. 2019;73(21):2673–75.

Public notes

Contacts

Principal investigator

Name

Prof David Playford

Address

School of Medicine
University of Notre Dame
32 Mouat Street,
Fremantle, WA 6959

Country

Australia

Phone

+61 8 9391 1234

Fax

dplayford@neda.net.au

Contact person for public queries

Name

Geoff Strange

Address

Cardiology
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050

Country

Australia

Phone

+61 422 308 585

Fax

gstrange@neda.net.au

Contact person for scientific queries

Name

Geoff Strange

Address

Cardiology
Royal Prince Alfred Hospital
Missenden Road
Camperdown NSW 2050

Country

Australia

Phone

+ 61 422 308 585

Fax

gstrange@neda.net.au

Data sharing statement

Will individual participant data (IPD) for this trial be available (including data dictionaries)?

No/undecided IPD sharing reason/comment

All data will be aggregated and no individual data will be available.

What supporting documents are/will be available?

No Supporting Document Provided

Results publications and other study-related documents

Documents added manually

No documents have been uploaded by study researchers.

Documents added automatically

Source	Title	Year of Publication	DOI
Embase	The National Echocardiography Database Australia (NEDA): Rationale and methodology.	2018	https://dx.doi.org/10.1016/j.ahj.2018.07.001
Embase	Threshold of Pulmonary Hypertension Associated With Increased Mortality.	2019	https://dx.doi.org/10.1016/j.jacc.2019.03.482
Embase	Enhanced Diagnosis of Severe Aortic Stenosis Using Artificial Intelligence: A Proof-of-Concept Study of 530,871 Echocardiograms.	2020	https://dx.doi.org/10.1016/j.jcmg.2019.10.013
Embase	Poor Survival with Impaired Valvular Hemodynamics After Aortic Valve Replacement: The National Echo Database Australia Study.	2020	https://dx.doi.org/10.1016/j.echo.2020.04.024
Embase	Change in ejection fraction and long-term mortality in adults referred for echocardiography.	2021	https://dx.doi.org/10.1002/ejhf.2161
Embase	Characteristics of bicuspid aortic valve disease and stenosis: The national echo database of Australia.	2021	https://dx.doi.org/10.1161/JAHA.121.020785
Embase	Ejection fraction and mortality: a nationwide register-based cohort study of 499 153 women and men.	2021	https://dx.doi.org/10.1002/ejhf.2047
Embase	Markers of Elevated Left Ventricular Filling Pressure Are Associated with Increased Mortality in Nonsevere Aortic Stenosis.	2021	https://dx.doi.org/10.1016/j.echo.2020.12.017
Embase	Preserved ejection fraction and structural heart disease in 446 848 patients investigated with echocardiography.	2021	https://dx.doi.org/10.1002/ehf2.13149
Embase	Prevalence and outcomes of low-gradient severe aortic stenosis-from the national echo database of Australia.	2021	https://dx.doi.org/10.1161/JAHA.121.021126
Embase	Prevalence, incidence and associates of pulmonary hypertension complicating type 2 diabetes: Insights from the fremantle diabetes study phase 2 and national echocardiographic database of Australia.	2021	https://dx.doi.org/10.3390/jcm10194503
Embase	Adverse Prognostic Impact of Even Mild or Moderate Tricuspid Regurgitation: Insights from the National Echocardiography Database of Australia.	2022	https://dx.doi.org/10.1016/j.echo.2022.04.003
Embase	Incident aortic stenosis in 49 449 men and 42 229 women investigated with routine echocardiography.	2022	https://dx.doi.org/10.1136/heartjnl-2021-319697
Embase	Prevalence and survival associated with pulmonary hypertension after mitral valve replacement: National echocardiography database of Australia study.	2022	https://dx.doi.org/10.1002/pul2.12140
Embase	Prevalence and prognostic impact of tricuspid regurgitation in patients with cardiac implantable electronic devices: From the national echocardiography database of Australia.	2023	https://dx.doi.org/10.1016/j.ijcard.2022.10.160
Embase	Prevalence of pulmonary hypertension in mitral regurgitation and its influence on outcomes.	2023	https://dx.doi.org/10.1136/openhrt-2023-002268
Embase	The association of resting heart rate with the development and progression of aortic stenosis.	2023	https://dx.doi.org/10.1093/ehjci/jead204
Embase	The prognostic significance of stroke volume index in low gradient severe aortic stenosis: from the national echo database of Australia.	2023	https://dx.doi.org/10.1007/s10554-023-02886-y
Embase	The Relationship between Pulmonary Artery Pressure and Mortality in Type 2 Diabetes: A Fremantle Diabetes Study Phase II and National Echocardiographic Database of Australia Data Linkage Study.	2023	https://dx.doi.org/10.3390/jcm12247685
Embase	The year 2022 in the European Heart Journal-Cardiovascular Imaging: Part I.	2023	https://dx.doi.org/10.1093/ehjci/jead237
Embase	Valvuloarterial Impedance and 5-Year Mortality in Severe Aortic Stenosis.	2023	https://dx.doi.org/10.14744/AnatolJCardiol.2022.2498
Dimensions AI	Incident pulmonary hypertension in 13 488 cases investigated with repeat echocardiography: a clinical cohort study	2023	https://doi.org/10.1183/23120541.00082-2023

N.B. These documents automatically identified may not have been verified by the study sponsor.

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