DOI
10.1136/bmjopen-2019-033084
Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis
作者地址
Lanzhou Univ, Hosp 1, Clin Med Sch 1, Lanzhou, Peoples R China
通讯作者
Bing Song; Jun-Qiang Lei
摘要
Objective To evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).
Design Systematic review and meta-analysis.
Data sources and eligibility criteria Embase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.
Main results A total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.
Conclusion TTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.
资助信息
Key Laboratory of Evidence Based Medicine and Knowledge Translation Foundation of Gansu Province GSXZYZH2018006
WOS学科分类
Medicine, General & Internal
WOS关键词
RIGHT HEART CATHETERIZATIONVENTRICULAR SYSTOLIC PRESSUREDOPPLER-ECHOCARDIOGRAPHYARTERIAL-HYPERTENSIONPORTOPULMONARY HYPERTENSIONMETHODOLOGICAL QUALITYASSOCIATIONTESTSECHOCANDIDATES
附件
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