目的提供欧洲心脏病学会(ESC)和美国心脏病学会/美国心脏协会(ACC/AHA)指南之间心脏MRI适应症的全面头对头比较和时间分析,以确定共识和分歧的领域。材料与方法进行系统评价和荟萃分析。直到2023年5月发布的ESC和ACC/AHA指南对与心脏MRI相关的建议进行了系统筛选。使用χ2或Fisher精确检验比较了两个指南之间以及每个指南的较新版本与较旧版本之间的心脏MRI建议的建议类别(COR)和证据水平(LOE)。结果ESC指南包括109条关于心脏MRI的建议,行政协调会/AHA准则包括90项建议。ACC/AHA指南中CORI和LOEB的比例高于ESC指南(60%[54/90]对46.8%[51/109];P=.06和53%[48/90]对35.8%[39/109],分别为;P=0.01)。随着时间的推移,ESC指南中心脏MRI推荐数量的增加显着增加(ESC从63到109,ACC/AHA从65到90;P=0.03)。达成共识的主要领域是心力衰竭和肥厚型心肌病,虽然主要的分歧是瓣膜性心脏病,心律失常,和主动脉疾病。结论ESC指南包括更多与心脏MRI使用相关的建议,而ACC/AHA建议的COR和LOE较高。在两个指南中,心脏MRI建议的数量随着时间的推移显著增加,表明心脏MRI评估和治疗心血管疾病的作用日益增强。关键词:心血管磁共振,Guideline,欧洲心脏病学会,ESC,美国心脏病学会/美国心脏协会,ACC/AHA补充材料可用于本文。©RSNA,2024.
Purpose To provide a comprehensive head-to-head comparison and temporal analysis of cardiac MRI indications between the European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines to identify areas of consensus and divergence. Materials and Methods A systematic
review and meta-analysis was conducted. ESC and ACC/AHA guidelines published until May 2023 were systematically screened for recommendations related to cardiac MRI. The class of recommendation (COR) and level of evidence (LOE) for cardiac MRI recommendations were compared between the two guidelines and between newer versus older versions of each guideline using χ2 or Fisher exact tests. Results ESC guidelines included 109 recommendations regarding cardiac MRI, and ACC/AHA guidelines included 90 recommendations. The proportion of COR I and LOE B was higher in ACC/AHA versus ESC guidelines (60% [54 of 90] vs 46.8% [51 of 109]; P = .06 and 53% [48 of 90] vs 35.8% [39 of 109], respectively; P = .01). The increase in the number of cardiac MRI recommendations over time was significantly higher in ESC guidelines (from 63 to 109 for ESC vs from 65 to 90 for ACC/AHA; P = .03). The main areas of consensus were found in heart failure and hypertrophic cardiomyopathy, while the main divergences were in valvular heart disease, arrhythmias, and aortic disease. Conclusion ESC guidelines included more recommendations related to cardiac MRI use, whereas the ACC/AHA recommendations had higher COR and LOE. The number of cardiac MRI recommendations increased significantly over time in both guidelines, indicating the increasing role of cardiac MRI evaluation and management of cardiovascular disease. Keywords: Cardiovascular Magnetic Resonance, Guideline, European Society of Cardiology, ESC, American College of Cardiology/American Heart Association, ACC/AHA Supplemental material is available for this article. © RSNA, 2024.