Head-to-Head Comparison and Temporal Trends of Cardiac MRI Recommendations in ESC versus ACC/AHA Guidelines: A Systematic Review and Meta-Analysis.
Nicola Ciocca, Henri Lu, Georgios Tzimas, Olivier Muller, Ambra Masi, Niccolò Maurizi, Ioannis Skalidis, Mark Colin Gissler, Pierre Monney, Juerg Schwitter, Yin Ge, Panagiotis Antiochos
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Abstract
Purpose To provide a comprehensive head-to-head comparison and temporal analysis of cardiac MRI indications between the European Society of Cardiology (ESC) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines to identify areas of consensus and divergence. Materials and Methods A systematic review and meta-analysis was conducted. ESC and ACC/AHA guidelines published until May 2023 were systematically screened for recommendations related to cardiac MRI. The class of recommendation (COR) and level of evidence (LOE) for cardiac MRI recommendations were compared between the two guidelines and between newer versus older versions of each guideline using χ2 or Fisher exact tests. Results ESC guidelines included 109 recommendations regarding cardiac MRI, and ACC/AHA guidelines included 90 recommendations. The proportion of COR I and LOE B was higher in ACC/AHA versus ESC guidelines (60% [54 of 90] vs 46.8% [51 of 109]; P = .06 and 53% [48 of 90] vs 35.8% [39 of 109], respectively; P = .01). The increase in the number of cardiac MRI recommendations over time was significantly higher in ESC guidelines (from 63 to 109 for ESC vs from 65 to 90 for ACC/AHA; P = .03). The main areas of consensus were found in heart failure and hypertrophic cardiomyopathy, while the main divergences were in valvular heart disease, arrhythmias, and aortic disease. Conclusion ESC guidelines included more recommendations related to cardiac MRI use, whereas the ACC/AHA recommendations had higher COR and LOE. The number of cardiac MRI recommendations increased significantly over time in both guidelines, indicating the increasing role of cardiac MRI evaluation and management of cardiovascular disease. Keywords: Cardiovascular Magnetic Resonance, Guideline, European Society of Cardiology, ESC, American College of Cardiology/American Heart Association, ACC/AHA Supplemental material is available for this article. © RSNA, 2024.
ESC与ACC/AHA指南中心脏磁共振成像建议的头对头比较和时间趋势:系统回顾和元分析。
目的 对欧洲心脏病学会 (ESC) 和美国心脏病学会/美国心脏协会 (ACC/AHA) 指南的心脏 MRI 适应症进行全面的头对头比较和时间分析,以确定共识和分歧的领域。材料和方法 进行了系统回顾和荟萃分析。系统地筛选了 2023 年 5 月之前发布的 ESC 和 ACC/AHA 指南中与心脏 MRI 相关的建议。使用χ2或费舍尔精确检验比较了两份指南之间以及每份指南的新版与旧版之间有关心脏磁共振成像建议的推荐级别(COR)和证据级别(LOE)。结果 ESC指南包括109条有关心脏MRI的建议,ACC/AHA指南包括90条建议。与ESC指南相比,ACC/AHA指南中COR I和LOE B的比例更高(分别为60% [90条中的54条] vs 46.8% [109条中的51条];P = .06和53% [90条中的48条] vs 35.8% [109条中的39条];P = .01)。随着时间的推移,ESC指南中心脏MRI建议数量的增加幅度明显更高(ESC从63条增加到109条,ACC/AHA从65条增加到90条;P = .03)。达成共识的主要领域是心力衰竭和肥厚型心肌病,而存在分歧的主要领域是瓣膜性心脏病、心律失常和主动脉疾病。结论 ESC 指南包含更多与心脏磁共振成像使用相关的建议,而 ACC/AHA 建议的 COR 和 LOE 较高。随着时间的推移,两种指南中心脏核磁共振成像建议的数量都有显著增加,这表明心脏核磁共振成像在心血管疾病的评估和管理中发挥着越来越重要的作用。关键词:心血管磁共振心血管磁共振;指南;欧洲心脏病学会;ESC;美国心脏病学会/美国心脏协会;ACC/AHA 本文有补充材料。© RSNA, 2024.
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