67 Echocardiography vs. computed tomography and cardiac magnetic resonance for the detection of left heart thrombosis: a systematic review and meta-analysis

Autor:	Dimitrios Delialis, Kimon Stamatelopoulos, Dimitrios Klettas, Georgios Ntritsos, Stefano Figliozzi, Michele Emdin, Georgios Georgiopoulos, Pier-Giorgio Masci, Alberto Aimo
Rok vydání:	2020
Předmět:	medicine.medical_specialty medicine.diagnostic_test business.industry Diastole Computed tomography medicine.disease Thrombosis Meta-analysis medicine Echocardiography transthoracic Radiology Cardiology and Cardiovascular Medicine business Cardiac magnetic resonance
Zdroj:	European Heart Journal Supplements. 22:N28-N44
ISSN:	1554-2815 1520-765X
DOI:	10.1093/eurheartj/suaa195
Popis:	Aims Accurate and reproducible diagnostic techniques are essential to detect left-sided cardiac thrombi (either in the left ventricle [LV] or in the left atrial appendage [LAA]) and to guide the onset and duration of antithrombotic treatment while minimizing the risk for thromboembolic and hemorrhagic events. Methods and results We conducted a systematic review and meta-analysis aiming to compare the diagnostic performance of transthoracic echocardiography (TTE) vs. cardiac magnetic resonance (CMR) for the detection of LV thrombi, and transesophageal echocardiography (TEE) vs. computed tomography (CT) for the detection of LAA thrombi. Six studies were included in the first meta-analysis. Pooled sensitivity and specificity values were 62% (95% confidence interval [CI], 37-81%) and 97% (95% CI, 94-99%). The shape of the hierarchical summary receiver operating characteristic (HSROC) curve and the area under the curve (AUC) of 0.96 suggested a high accuracy. Ten studies were included in the meta-analysis of the diagnostic accuracy of CT vs. TEE. The pooled values of sensitivity and specificity were 97% (95% CI, 77-100%) and 94% (95% CI, 87-98%). The pooled DOR was 500 (95% CI, 52-4810), and the pooled LR+ and LR- values were 17% (95% CI, 7-40%) and 3% (95% CI, 0-28%). The shape of the HSROC curve and the 0.99 AUC suggested a high accuracy of CT vs. TEE. Conclusion TTE is a valid alternative to DE-CMR for the identification of LV thrombi, and CT has a good accuracy compared to TEE for the detection of LAA thrombosis.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::f1232d6471bf084e56d21b26d6f5b5eb https://doi.org/10.1093/eurheartj/suaa195 Zobrazit plný text záznamu