Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses
Abstract Background The role of echocardiography in the diagnostic and prognostic assessment of pulmonary hypertension (PH) has been widely studied recently. However, these findings have not undergone normative evaluation and may provide confusing evidence for clinicians. To evaluate and summarize e...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Pulmonary Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12890-023-02552-y |
| _version_ | 1827900103553187840 |
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| author | Tian-Xin Dong Qing Zhu Shi-Tong Wang Yong-Huai Wang Guang-Yuan Li Fan-Xin Kong Chun-Yan Ma |
| author_facet | Tian-Xin Dong Qing Zhu Shi-Tong Wang Yong-Huai Wang Guang-Yuan Li Fan-Xin Kong Chun-Yan Ma |
| author_sort | Tian-Xin Dong |
| collection | DOAJ |
| description | Abstract Background The role of echocardiography in the diagnostic and prognostic assessment of pulmonary hypertension (PH) has been widely studied recently. However, these findings have not undergone normative evaluation and may provide confusing evidence for clinicians. To evaluate and summarize existing evidence, we performed an umbrella review. Methods Systematic reviews and meta-analyses were searched in PubMed, Embase, Web of Science, and Cochrane Library from inception to September 4, 2022. The methodological quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to evaluate the quality of evidence. Results Thirteen meta-analyses (nine diagnostic and four prognostic studies) were included after searching four databases. The methodological quality of the included studies was rated as high (62%) or moderate (38%) by AMSTAR. The thirteen included meta-analyses involved a total of 28 outcome measures. The quality of evidence for these outcomes were high (7%), moderate (29%), low (39%), and very low (25%) using GRADE methodology. In the detection of PH, the sensitivity of systolic pulmonary arterial pressure is 0.85–0.88, and the sensitivity and specificity of right ventricular outflow tract acceleration time are 0.84. Pericardial effusion, right atrial area, and tricuspid annulus systolic displacement provide prognostic value in patients with pulmonary arterial hypertension with hazard ratios between 1.45 and 1.70. Meanwhile, right ventricular longitudinal strain has independent prognostic value in patients with PH, with a hazard ratio of 2.96–3.67. Conclusion The umbrella review recommends echocardiography for PH detection and prognosis. Systolic pulmonary arterial pressure and right ventricular outflow tract acceleration time can be utilized for detection, while several factors including pericardial effusion, right atrial area, tricuspid annular systolic displacement, and right ventricular longitudinal strain have demonstrated prognostic significance. Trial registration PROSPERO (CRD42022356091), https://www.crd.york.ac.uk/prospero/ . |
| first_indexed | 2024-03-12T23:26:30Z |
| format | Article |
| id | doaj.art-bc221f17a1bc410580868fe1131da43f |
| institution | Directory Open Access Journal |
| issn | 1471-2466 |
| language | English |
| last_indexed | 2024-03-12T23:26:30Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pulmonary Medicine |
| spelling | doaj.art-bc221f17a1bc410580868fe1131da43f2023-07-16T11:08:16ZengBMCBMC Pulmonary Medicine1471-24662023-07-0123111010.1186/s12890-023-02552-yDiagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analysesTian-Xin Dong0Qing Zhu1Shi-Tong Wang2Yong-Huai Wang3Guang-Yuan Li4Fan-Xin Kong5Chun-Yan Ma6Department of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityDepartment of Cardiovascular Ultrasound, The First Hospital of China Medical UniversityAbstract Background The role of echocardiography in the diagnostic and prognostic assessment of pulmonary hypertension (PH) has been widely studied recently. However, these findings have not undergone normative evaluation and may provide confusing evidence for clinicians. To evaluate and summarize existing evidence, we performed an umbrella review. Methods Systematic reviews and meta-analyses were searched in PubMed, Embase, Web of Science, and Cochrane Library from inception to September 4, 2022. The methodological quality of the included studies was assessed using Assessment of Multiple Systematic Reviews (AMSTAR), and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to evaluate the quality of evidence. Results Thirteen meta-analyses (nine diagnostic and four prognostic studies) were included after searching four databases. The methodological quality of the included studies was rated as high (62%) or moderate (38%) by AMSTAR. The thirteen included meta-analyses involved a total of 28 outcome measures. The quality of evidence for these outcomes were high (7%), moderate (29%), low (39%), and very low (25%) using GRADE methodology. In the detection of PH, the sensitivity of systolic pulmonary arterial pressure is 0.85–0.88, and the sensitivity and specificity of right ventricular outflow tract acceleration time are 0.84. Pericardial effusion, right atrial area, and tricuspid annulus systolic displacement provide prognostic value in patients with pulmonary arterial hypertension with hazard ratios between 1.45 and 1.70. Meanwhile, right ventricular longitudinal strain has independent prognostic value in patients with PH, with a hazard ratio of 2.96–3.67. Conclusion The umbrella review recommends echocardiography for PH detection and prognosis. Systolic pulmonary arterial pressure and right ventricular outflow tract acceleration time can be utilized for detection, while several factors including pericardial effusion, right atrial area, tricuspid annular systolic displacement, and right ventricular longitudinal strain have demonstrated prognostic significance. Trial registration PROSPERO (CRD42022356091), https://www.crd.york.ac.uk/prospero/ .https://doi.org/10.1186/s12890-023-02552-yEchocardiographyPulmonary hypertensionDiagnostic valueRight ventricular longitudinal strainUmbrella review |
| spellingShingle | Tian-Xin Dong Qing Zhu Shi-Tong Wang Yong-Huai Wang Guang-Yuan Li Fan-Xin Kong Chun-Yan Ma Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses BMC Pulmonary Medicine Echocardiography Pulmonary hypertension Diagnostic value Right ventricular longitudinal strain Umbrella review |
| title | Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses |
| title_full | Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses |
| title_fullStr | Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses |
| title_full_unstemmed | Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses |
| title_short | Diagnostic and prognostic value of echocardiography in pulmonary hypertension: an umbrella review of systematic reviews and meta-analyses |
| title_sort | diagnostic and prognostic value of echocardiography in pulmonary hypertension an umbrella review of systematic reviews and meta analyses |
| topic | Echocardiography Pulmonary hypertension Diagnostic value Right ventricular longitudinal strain Umbrella review |
| url | https://doi.org/10.1186/s12890-023-02552-y |
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