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Canadian Journal of Cardiology

A Systematic Review of the Diagnostic Accuracy of Cardiovascular Magnetic Resonance for Pulmonary Hypertension

  • Ning Wang
    Affiliations
    Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing, China
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  • Xiaolan Hu
    Affiliations
    Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
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  • Chenjing Liu
    Affiliations
    Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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  • Bihi Ali
    Affiliations
    Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
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  • Xiaojuan Guo
    Affiliations
    Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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  • Min Liu
    Affiliations
    Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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  • Xiaoxia Peng
    Correspondence
    Corresponding author: Dr Xiaoxia Peng, Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, No.10 Xitoutiao, You An Men, Beijing 100069, China.
    Affiliations
    Department of Epidemiology and Biostatistics, School of Public Health and Family Medicine, Capital Medical University, Beijing, China

    Beijing Municipal Key Lab of Clinical Epidemiology, Beijing, China
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  • YuanHua Yang
    Correspondence
    Corresponding author: Dr YuanHua Yang, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongtinanlu, Chao-Yang District, Beijing 100020, China. Tel.: +86-10-85231437; fax: +86-10-65030135.
    Affiliations
    Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing, China
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Published:December 05, 2013DOI:https://doi.org/10.1016/j.cjca.2013.11.028

      Abstract

      Background

      The diagnostic accuracy of cardiovascular magnetic resonance (CMR) for pulmonary hypertension (PH) compared with right heart catheterization were assessed. The purpose of this systematic review was to comprehensively evaluate the diagnostic accuracy of CMR in evaluating PH.

      Methods

      Published literature was obtained from PUBMED, Web of Knowledge, Cochrane library, Embase, Biosis Preview, China National Knowledge Infrastructure, and Chongqing VIP databases, and all studies were inclusive until December 2012. Studies relevant to PH and its imaging in CMR and right heart catheterization were included if correlation coefficient was elucidated clearly. Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) score was used to assess the quality of studies. Sensitivity and specificity were pooled separately and compared with overall accuracy measures: diagnostic odds ratio and symmetric summary receiver operating characteristic.

      Results

      Sixteen studies were included in the systematic review. Of all the studies, the most widely used index was ventricular mass index (VMI) of CMR. We performed a meta-analysis for VMI among 429 patients in 5 individual studies, which showed a modest diagnostic accuracy of VMI for PH with a summary sensitivity and specificity of 84% (95% confidence interval, 79%-87%) and 82% (95% confidence interval, 73%-89%), respectively. In addition, the summary positive likelihood ratio was 4.894, indicating that VMI of CMR allows a modest ability to distinguish PH patients from healthy subjects with a cutoff point of 0.45 using functional and structural measures.

      Conclusions

      This systematic review and meta-analysis indicates that VMI seems to have a moderate sensitivity and specificity for detection of PH. The application values of other parameters still need further investigation.

      Résumé

      Introduction

      Nous avons évalué la précision diagnostique de la résonance magnétique cardiovasculaire (RMC) par rapport à celle du cathétérisme du cœur droit concernant l’hypertension pulmonaire (HP). Le but de cette revue systématique était d’évaluer de manière détaillée la précision diagnostique de la RMC lors de l’évaluation de l’HP.

      Méthodes

      La littérature publiée a été obtenue des bases de données de PUBMED, du Web of Knowledge, de la Bibliothèque Cochrane, d’EMBASE, de Biosis Previews, de la China National Knowledge Infrastructure et de Chongquing VIP, et toutes les études ont été incluses jusqu’en décembre 2012. Les études applicables à l’HP et leur imagerie de la RMC et du cathétérisme du cœur droit ont été incluses si le coefficient de corrélation était bien élucidé. Le score du QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) a été utilisé pour évaluer la qualité des études. La sensibilité et la spécificité ont été regroupées séparément et comparées à l’ensemble des mesures de précision : le ratio d’incidence approché diagnostique et la courbe caractéristique sommaire symétrique d’efficacité du récepteur.

      Résultats

      Seize (16) études ont été incluses dans la revue systématique. Parmi toutes les études, l’indice le plus communément utilisé était l’indice de masse ventriculaire (IMV) de la RMC. Nous avons réalisé une méta-analyse de l’IMV parmi les 429 patients de 5 études individuelles, qui montraient respectivement une précision diagnostique modeste de l’IMV de l’HP par une sensibilité et une spécificité sommaire de 84 % (intervalle de confiance à 95 %, 79 %-87 %) et de 82 % (intervalle de confiance à 95 %, 73 %-89 %). De plus, le rapport de vraisemblance positif sommaire a été de 4,894, ce qui indique que l’IMV de la RMC permet modestement de distinguer les patients ayant une HP des sujets en santé selon une limite d’inclusion de 0,45 en utilisant les mesures fonctionnelles et structurelles.

      Conclusions

      La revue systématique et la méta-analyse indiquent que l’IMV semble avoir une sensibilité et une spécificité modérées de détection de l’HP. Les valeurs d’application des autres paramètres exigent des études ultérieures.
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