Quantitative Myocardial Contrast Echocardiography during Pharmacological Stress for Diagnosis of Coronary Artery Disease: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies

Abdelmoneim, S. S.; Dhoble, A.; Bernier, M.; Erwin, P. J.; Korosoglou, G.; Senior, R.; Moir, S.; Kowatsch, I.; Xian-Hong, S.; Muro, T.; Dawson, D.; Vogel, Rolf; Wei, K.; West, C. P.; Montori, V. M.; Pellikka, P. A.; Abdel-Kader, S. S.; Mulvagh, S. L. (2009). Quantitative Myocardial Contrast Echocardiography during Pharmacological Stress for Diagnosis of Coronary Artery Disease: A Systematic Review and Meta-analysis of Diagnostic Accuracy Studies. European Journal Echocardiography, 10(7), pp. 813-825. Oxford Journals 10.1093/ejechocard/jep084

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AIMS: We conducted a meta-analysis to evaluate the accuracy of quantitative stress myocardial contrast echocardiography (MCE) in coronary artery disease (CAD). METHODS AND RESULTS: Database search was performed through January 2008. We included studies evaluating accuracy of quantitative stress MCE for detection of CAD compared with coronary angiography or single-photon emission computed tomography (SPECT) and measuring reserve parameters of A, beta, and Abeta. Data from studies were verified and supplemented by the authors of each study. Using random effects meta-analysis, we estimated weighted mean difference (WMD), likelihood ratios (LRs), diagnostic odds ratios (DORs), and summary area under curve (AUC), all with 95% confidence interval (CI). Of 1443 studies, 13 including 627 patients (age range, 38-75 years) and comparing MCE with angiography (n = 10), SPECT (n = 1), or both (n = 2) were eligible. WMD (95% CI) were significantly less in CAD group than no-CAD group: 0.12 (0.06-0.18) (P < 0.001), 1.38 (1.28-1.52) (P < 0.001), and 1.47 (1.18-1.76) (P < 0.001) for A, beta, and Abeta reserves, respectively. Pooled LRs for positive test were 1.33 (1.13-1.57), 3.76 (2.43-5.80), and 3.64 (2.87-4.78) and LRs for negative test were 0.68 (0.55-0.83), 0.30 (0.24-0.38), and 0.27 (0.22-0.34) for A, beta, and Abeta reserves, respectively. Pooled DORs were 2.09 (1.42-3.07), 15.11 (7.90-28.91), and 14.73 (9.61-22.57) and AUCs were 0.637 (0.594-0.677), 0.851 (0.828-0.872), and 0.859 (0.842-0.750) for A, beta, and Abeta reserves, respectively. CONCLUSION: Evidence supports the use of quantitative MCE as a non-invasive test for detection of CAD. Standardizing MCE quantification analysis and adherence to reporting standards for diagnostic tests could enhance the quality of evidence in this field.

Item Type:	Journal Article (Original Article)
Division/Institute:	10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE) > ARTORG Center - Cardiovascular Engineering (Blood Vessel) 10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)
UniBE Contributor:	Vogel, Rolf
ISSN:	1532-2114
Publisher:	Oxford Journals
Language:	English
Submitter:	Francesco Clavica
Date Deposited:	11 Jul 2014 09:06
Last Modified:	05 Dec 2022 14:33
Publisher DOI:	10.1093/ejechocard/jep084
PubMed ID:	19549700
Uncontrolled Keywords:	Adult, Aged, Contrast Media, Coronary Artery Disease,Coronary Circulation, Echocardiography, Exercise Test, Female, Heart, Humans, Male, Microcirculation, Middle Aged, Radiopharmaceuticals
URI:	https://boris.unibe.ch/id/eprint/50835