Prognostic value of resting myocardial contrast echocardiography: a meta-analysis.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Echo Research and Practice Pub Date : 2020-09-01 DOI:10.1530/ERP-20-0023

Lijun Qian, Feng Xie, Di Xu, Thomas R Porter

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引用次数: 2

Abstract

Background: Resting myocardial perfusion (MP) and wall motion (WM) imaging during real-time myocardial contrast echocardiography (MCE) improves the detection of coronary artery disease (CAD). However, its prognostic role in different clinical settings (emergency department and outpatient setting) remains unclear.

Methods: A systematic search in PubMed and Embase databases, and the Cochrane library, was conducted to evaluate the role of resting MP and WM in predicting major adverse cardiac events (MACE), including death, nonfatal myocardial infarction (NFMI) and urgent revascularization in patients presenting to either outpatient clinics or emergency departments with suspected symptomatic CAD. Summary receiver operating characteristic (SROC) curves, sensitivity and specificity plots were applied to assess diagnostic performance using RevMan 5.3.

Results: Seven studies met criteria, including 3668 patients (six with follow up ranging from 2 days to 2.6 years). The Relative Risk (RR) for predicting MACE in patients with both abnormal resting MP and WM was 6.1 (95% CI, 5.1-7.2) and 14.3 (95% CI, 10.3-19.8) for death/NFMI, when compared to normal resting MP and WM patients. Having both abnormal resting MP and WM was also more predictive of MACE (RR, 1.7; 95% CI 1.5-1.9) and death/NFMI (RR, 2.2; 95% CI, 1.8-2.7) when compared to abnormal WM with normal resting MP.

Conclusion: In this meta-analysis of both ED and outpatient clinic presentations for suspected CAD, having both a resting regional MP and WM abnormality identifies the highest risk patient for adverse events.

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静息心肌超声造影的预后价值:一项荟萃分析。

背景:实时心肌对比超声心动图(MCE)中静息心肌灌注(MP)和壁运动(WM)成像可提高冠状动脉疾病(CAD)的检出率。然而，其在不同临床环境(急诊科和门诊)中的预后作用仍不清楚。方法:系统检索PubMed和Embase数据库以及Cochrane图书馆，评估静息MP和WM在预测主要不良心脏事件(MACE)中的作用，包括死亡、非致死性心肌梗死(NFMI)和急诊疑似症状性CAD患者的紧急血运重建术。应用RevMan 5.3软件评价患者的诊断效果，采用SROC曲线、敏感性和特异性图。结果:7项研究符合标准，包括3668例患者(6例随访时间从2天到2.6年不等)。与正常静息MP和WM患者相比，静息MP和WM异常患者预测MACE死亡/NFMI的相对危险度(RR)分别为6.1 (95% CI, 5.1-7.2)和14.3 (95% CI, 10.3-19.8)。静息MP和WM均异常也更能预测MACE (RR, 1.7;95% CI 1.5-1.9)和死亡/NFMI (RR, 2.2;95% CI, 1.8-2.7)，比较异常WM和正常静息MP。结论:在这项对疑似CAD患者的ED和门诊表现的荟萃分析中，静息区MP和WM均异常的患者可识别出发生不良事件的最高风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Echo Research and Practice CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.70

自引率

12.70%

发文量

审稿时长

8 weeks

期刊介绍： Echo Research and Practice aims to be the premier international journal for physicians, sonographers, nurses and other allied health professionals practising echocardiography and other cardiac imaging modalities. This open-access journal publishes quality clinical and basic research, reviews, videos, education materials and selected high-interest case reports and videos across all echocardiography modalities and disciplines, including paediatrics, anaesthetics, general practice, acute medicine and intensive care. Multi-modality studies primarily featuring the use of cardiac ultrasound in clinical practice, in association with Cardiac Computed Tomography, Cardiovascular Magnetic Resonance or Nuclear Cardiology are of interest. Topics include, but are not limited to: 2D echocardiography 3D echocardiography Comparative imaging techniques – CCT, CMR and Nuclear Cardiology Congenital heart disease, including foetal echocardiography Contrast echocardiography Critical care echocardiography Deformation imaging Doppler echocardiography Interventional echocardiography Intracardiac echocardiography Intraoperative echocardiography Prosthetic valves Stress echocardiography Technical innovations Transoesophageal echocardiography Valve disease.