Dobutamine Stress Echocardiography in the Assessment of Cardiac Allograft Vasculopathy in Asymptomatic Recipients

Sade, Leyla Elif; Sezgin, Alpay Turan; Eroğlu, Serpil; Bozbaş, Hüseyin; Uluçam, Melek; Müderrisoğlu, H.

doi:10.1016/j.transproceed.2007.11.038

Cited by 9 publications

(11 citation statements)

References 14 publications

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“…Eleven studies (749 participants) compared DSE to CA or IVUS . The sensitivity of DSE varied from 1.7% to 93.8%, and specificity, from 54.8% to 98.8%.…”

Section: Resultsmentioning

confidence: 99%

“…Three studies had a high risk of bias in flow and timing; two of them were retrospective . Meta‐regression revealed that study design (prospective or retrospective) was significantly affecting the estimated accuracy of DSE ( x 2 = 20.4, P < 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Meta‐regression revealed that study design (prospective or retrospective) was significantly affecting the estimated accuracy of DSE ( x 2 = 20.4, P < 0.001). Among prospective studies, the study with risk of bias in flow and timing had no statistically significant effect on estimating the accuracy of DSE ( x 2 = 0.15, P = 0.927) . Thus, subgroup analysis was conducted with exclusion of the two retrospective studies only …”

Section: Resultsmentioning

confidence: 99%

“…The present meta‐analysis has demonstrated a low sensitivity of 60.2% but a much higher specificity of 85.7% for DSE for detection of CAV. Initial published studies showed a good level of both sensitivity and specificity for DSE . However, two studies published later on by Chirakarnjanakorn et al, and Clerkin et al showed a significantly lower sensitivity and specificity of 7% and 1.7%, respectively .…”

Section: Discussionmentioning

confidence: 96%

“…One such modality is dobutamine stress echocardiography (DSE); initial studies showed it to be useful in detecting CAV by stress‐induced ventricular wall‐motion abnormalities, but subsequent studies showed the technique to have limited value. In order to determine what true value DSE has in the detection of early CAV, we performed a systematic literature review and meta‐analysis of all published studies that examined the diagnostic accuracy of DSE in comparison with either CA or IVUS …”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of dobutamine stress echocardiography in the detection of cardiac allograft vasculopathy in heart transplant recipients: A systematic review and meta‐analysis study

et al. 2019

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Background Dobutamine stress echocardiography (DSE) is a well‐established imaging modality used to screen patients with mild‐to‐moderate risk for coronary artery disease. In heart transplantation recipients, cardiac allograft vasculopathy (CAV) is a common and lethal complication. The use of DSE to detect CAV showed promising results initially, but later studies showed limitation in its use to detect CAV. It is unclear if this cohort of patients derives benefit from DSE. Methods We searched PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and Scopus from inception through March 2018 for studies examining the accuracy of DSE in correlation to coronary angiography (CA) or intravascular ultrasound (IVUS) to detect CAV. Original studies comparing the ability of DSE to detect CAV in comparison with CA or IVUS were included. Relevant data were extracted and hierarchical summary receiver operating characteristic analysis was conducted to test the overall diagnostic accuracy of DSE for patients with CAV. Results Eleven studies (749 participants) met the inclusion criteria. The sensitivity of DSE varied from 1.7% to 93.8%, and specificity, from 54.8% to 98.8%. Pooled sensitivity was 60.2% (95% confidence interval (CI), 33.0%–82.3%) and specificity 85.7% (95% CI, 73.8%–92.7%). DSE had an overall diagnostic odds ratio (OR) of 9.1 (95% CI, 4.6–17.8), positive likelihood ratio (LR+) of 4.1 (95% CI, 2.8–6.1), negative likelihood ratio (LR−) of 0.47 (95% CI: 0.23–0.73), and area under curve (AUC) of 0.73 (95% CI, 0.72–0.75). Heterogeneity among studies was not statistically significant (τ2 = 0.32, Cochran's Q = 9.5, P = 0.483). Conclusion Dobutamine stress echocardiography has a limited sensitivity to detect early CAV but its specificity is much higher. There remains a need for an alternative noninvasive modality which will have both high sensitivity and high specificity for detecting CAV.

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“…Eleven studies (749 participants) compared DSE to CA or IVUS . The sensitivity of DSE varied from 1.7% to 93.8%, and specificity, from 54.8% to 98.8%.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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