虽然经胸三维超声心动图(3DE)现在推荐左心室(LV)容积测量指南,由于时间限制和所需的专业知识,广泛的实施受到限制。我们假设全自动3DE左心室定量软件可以提供准确的测量,它的应用可以消除这些障碍。
为了解决这个假设,在使用全自动3DE软件(HeartModel或DynamicHeartModel,飞利浦医疗保健,安多佛,MA,美国)与心脏磁共振(CMR),从2015年到2021年。随机效应模型被用来确定偏见,相关性,和左心室舒张末期容积(EDV)的95%置信区间(CI),收缩末期容积(ESV),和EF。进行亚组和荟萃回归分析以确定调节者对结果的影响。
在12项研究中(616项受试者),EDV的平均差异和95%CI,ESV,全自动3DE软件和CMR之间的EF为-19.6mL(95%CI;-27.6至-11.5mL),-11.4毫升(-16.7至-6.2毫升),和0.4%(-1.1%至2.0%),分别。两种方法的相关值分别为0.91(0.86-0.94),0.89(0.82-0.93),和0.85(0.81-0.88),分别。荟萃回归分析显示,这两个发表年份都没有影响,软件类型,或对LV体积和功能参数结果的分析类型,LVESV相关值的发表年份除外。
尽管3DE仍然低估了LV的容量,观察到的差异不>20mL。EF显示与CMR相似的值。两种技术之间的良好相关性使全自动3DE左室定量软件可用于成人人群的常规临床实践。
Although transthoracic three-dimensional echocardiography (3DE) is now recommended by guidelines for left ventricular (LV) volumetric measurements, widespread implementation has been limited due to time constraints and required expertise. We hypothesized that fully automated 3DE left chamber quantification software might provide accurate measurements, and that its application could eliminate these obstacles.
To address this hypothesis, we conducted a systematic
review and meta-analysis following a search for studies that compared LV volumes and ejection fraction (EF) using fully automated 3DE software (HeartModel or Dynamic HeartModel, Philips Healthcare, Andover, MA, USA) with cardiac magnetic resonance (CMR), from 2015 to 2021. A random effects model was used to determine biases, correlations, and 95 % confidence intervals (CI) of LV end-diastolic volume (EDV), end-systolic volume (ESV), and EF. Subgroup and meta-regression analyses were performed to determine effects of moderators on the outcome.
Of 12 studies (616 subjects), mean differences and 95 % CIs in EDV, ESV, and EF between fully automated 3DE software and CMR were -19.6 mL (95 % CI; -27.6 to -11.5 mL), -11.4 mL (-16.7 to -6.2 mL), and 0.4 % (-1.1 to 2.0 %), respectively. Corresponding correlation values between the two methods were 0.91 (0.86-0.94), 0.89 (0.82-0.93), and 0.85 (0.81-0.88), respectively. Meta-regression analysis revealed that there were no effects of either publication year, type of software, or type of analysis on the outcome of LV volumetric and functional parameters except for publication year on LVESV correlation values.
Although 3DE still underestimates LV volumes, the observed differences were no >20 mL. EF showed similar values to CMR. Excellent correlations between the two techniques make fully automated 3DE left chamber quantification software useful for routine clinical practice in adult population.