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Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis

PURPOSE: Cardiac MR (CMR) is the gold standard for left ventricular (LV) quantification. However, two-dimensional echocardiography (2DE) is the most common approach, and both three-dimensional echocardiography (3DE) and multidetector CT (MDCT) are increasingly available. The clinical significance an...

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Autores principales: Rigolli, Marzia, Anandabaskaran, Sulakchanan, Christiansen, Jonathan P, Whalley, Gillian A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854151/
https://www.ncbi.nlm.nih.gov/pubmed/27158524
http://dx.doi.org/10.1136/openhrt-2015-000388
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author Rigolli, Marzia
Anandabaskaran, Sulakchanan
Christiansen, Jonathan P
Whalley, Gillian A
author_facet Rigolli, Marzia
Anandabaskaran, Sulakchanan
Christiansen, Jonathan P
Whalley, Gillian A
author_sort Rigolli, Marzia
collection PubMed
description PURPOSE: Cardiac MR (CMR) is the gold standard for left ventricular (LV) quantification. However, two-dimensional echocardiography (2DE) is the most common approach, and both three-dimensional echocardiography (3DE) and multidetector CT (MDCT) are increasingly available. The clinical significance and interchangeability of these modalities remains under-investigated. Therefore, we undertook a systemic review to evaluate the accuracy and absolute bias in LV quantification of all the commonly available non-invasive imaging modalities (2DE, CE-2DE, 3DE, MDCT) compared to cardiac MR (CMR). METHODS: Studies were included that reported LV echocardiographic (2DE, CE-2DE, 3DE) and/or MDCT measurements compared to CMR. Only modern CMR (SSFP sequences) was considered. Studies involving small sample size (<10 patients) and unusual cardiac geometry (ie, congenital heart diseases) were excluded. We evaluated LV end-diastolic volume (LVEDV), end-systolic volume (LVESV) and ejection fraction (LVEF). RESULTS: 1604 articles were initially considered: 65 studies were included (total of 4032 scans (echo, CT, MRI) performed in 2888 patients). Compared to CMR, significant biased underestimation of LV volumes with 2DE was seen (LVEDV—33.30 mL, LVESV −16.20 mL, p<0.0001). This difference was reduced but remained significant with CE-2DE (LVEDV −18.05, p<0.0001) and 3DE (LVEDV −14.41, p<0.001), while MDCT values were similar to CMR (LVEDV −1.20, p=0.43; LVESV −0.13, p=0.91). However, excellent agreement for echocardiographic LVEF evaluation (2DE LVEF 0.78–1.01%, p=0.37) was observed, especially with 3DE (LVEF 0.14%, p=0.88). CONCLUSIONS: Comparing imaging modalities to CMR as reference standard, 3DE had the highest accuracy in LVEF estimation: 2DE and 3DE-derived LV volumes were significantly underestimated. Newer generation CT showed excellent accuracy for LV volumes.
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spelling pubmed-48541512016-05-06 Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis Rigolli, Marzia Anandabaskaran, Sulakchanan Christiansen, Jonathan P Whalley, Gillian A Open Heart Meta-Analysis PURPOSE: Cardiac MR (CMR) is the gold standard for left ventricular (LV) quantification. However, two-dimensional echocardiography (2DE) is the most common approach, and both three-dimensional echocardiography (3DE) and multidetector CT (MDCT) are increasingly available. The clinical significance and interchangeability of these modalities remains under-investigated. Therefore, we undertook a systemic review to evaluate the accuracy and absolute bias in LV quantification of all the commonly available non-invasive imaging modalities (2DE, CE-2DE, 3DE, MDCT) compared to cardiac MR (CMR). METHODS: Studies were included that reported LV echocardiographic (2DE, CE-2DE, 3DE) and/or MDCT measurements compared to CMR. Only modern CMR (SSFP sequences) was considered. Studies involving small sample size (<10 patients) and unusual cardiac geometry (ie, congenital heart diseases) were excluded. We evaluated LV end-diastolic volume (LVEDV), end-systolic volume (LVESV) and ejection fraction (LVEF). RESULTS: 1604 articles were initially considered: 65 studies were included (total of 4032 scans (echo, CT, MRI) performed in 2888 patients). Compared to CMR, significant biased underestimation of LV volumes with 2DE was seen (LVEDV—33.30 mL, LVESV −16.20 mL, p<0.0001). This difference was reduced but remained significant with CE-2DE (LVEDV −18.05, p<0.0001) and 3DE (LVEDV −14.41, p<0.001), while MDCT values were similar to CMR (LVEDV −1.20, p=0.43; LVESV −0.13, p=0.91). However, excellent agreement for echocardiographic LVEF evaluation (2DE LVEF 0.78–1.01%, p=0.37) was observed, especially with 3DE (LVEF 0.14%, p=0.88). CONCLUSIONS: Comparing imaging modalities to CMR as reference standard, 3DE had the highest accuracy in LVEF estimation: 2DE and 3DE-derived LV volumes were significantly underestimated. Newer generation CT showed excellent accuracy for LV volumes. BMJ Publishing Group 2016-04-27 /pmc/articles/PMC4854151/ /pubmed/27158524 http://dx.doi.org/10.1136/openhrt-2015-000388 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Meta-Analysis
Rigolli, Marzia
Anandabaskaran, Sulakchanan
Christiansen, Jonathan P
Whalley, Gillian A
Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title_full Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title_fullStr Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title_full_unstemmed Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title_short Bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
title_sort bias associated with left ventricular quantification by multimodality imaging: a systematic review and meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4854151/
https://www.ncbi.nlm.nih.gov/pubmed/27158524
http://dx.doi.org/10.1136/openhrt-2015-000388
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