Ecocardiografia por Doppler tecidual no diagnóstico de rejeição após transplante cardíaco

ObjectiveMany studies have addressed the diagnostic performance of echocardiography to evaluate acute cardiac allograft rejection compared with endomyocardial biopsy. But the existence of heterogeneity limited its clinical application. Thus, we conducted a comprehensive, systematic literature review and meta-analysis for the purpose.MethodsStudies prior to September 1, 2014 identified by Medline/PubMed, EMBASE and Cochrance were examined by two independent reviews. We conducted meta-analysis by using Meta-DiSc 1.4 software. An assessment tool of QUADAS-2 was applied to evaluate the risk of bias and applicability of the studies.ResultsThirty studies met the inclusion criteria of meta-analysis. The four parameters of pressure half time, isovolumic relaxation time, index of myocardial performance and late diastolic mitral annular motion velocity were included in the meta-analysis, with a pooled diagnostic odds ratio of 10.43, 6.89, 15.95 and 5.68 respectively, and the area under the summary receiver operating characteristic curves value of 0.829, 0.599, 0.871 and 0.685 respectively.ConclusionThe meta-analysis and systematic review demonstrate that no single parameter of echocardiography showed a reliable diagnostic performance for acute cardiac allograft rejection. A result of echocardiography for ACAR should be comprehensively considered by physicians in the context of clinical presentations and imaging feature.

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Section: Resultsmentioning

confidence: 99%

Diagnostic Performance of Echocardiography for the Detection of Acute Cardiac Allograft Rejection: A Systematic Review and Meta-Analysis

et al. 2015

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Non-invasive cardiac allograft rejection surveillance: reliability and clinical value for prevention of heart failure

Dandel

Hetzer²

2020

Heart Fail Rev

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Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: Usefulness of myocardial velocity and deformation imaging

Dandel

Hetzer

2017

The Journal of Heart and Lung Transplantation

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Ecocardiografia por Doppler tecidual no diagnóstico de rejeição após transplante cardíaco

Abstract: Background: Endomyocardial biopsy (EMB) is the gold standard method for the diagnosis of cellular rejection (CR) after heart transplantation (HT).

Cited by 9 publications

References 27 publications

Diagnostic Performance of Echocardiography for the Detection of Acute Cardiac Allograft Rejection: A Systematic Review and Meta-Analysis

Diagnostic Performance of Echocardiography for the Detection of Acute Cardiac Allograft Rejection: A Systematic Review and Meta-Analysis

Non-invasive cardiac allograft rejection surveillance: reliability and clinical value for prevention of heart failure

Post-transplant surveillance for acute rejection and allograft vasculopathy by echocardiography: Usefulness of myocardial velocity and deformation imaging

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