心脏磁共振得出的右心室射血分数对不良预后的影响:强大的贝叶斯模型平均 Meta 分析。

IF 4.2 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Magnetic Resonance Pub Date : 2024-10-27 DOI:10.1016/j.jocmr.2024.101118
Tetsuji Kitano, František Bartoš, Yosuke Nabeshima, Alex Ali Sayour, Attila Kovacs, Masaaki Takeuchi
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引用次数: 0

摘要

背景:很少有荟萃分析研究右心室射血分数(RVEF)对特定类型心血管疾病(CVD)的预后价值。本研究的目的是采用稳健的贝叶斯模型平均荟萃分析,比较心脏磁共振(CMR)得出的 RVEF 与几种特定类型心血管疾病的不良预后之间的关系:在三个数据库中搜索了报告特定类型心血管疾病 RVEF 危险比 (HRs) 的 CMR 文章。针对每种特定类型的心血管疾病,分别进行了贝叶斯模型平均荟萃分析,并根据贝叶斯因子(BF)评估了RVEF的证据强度:在对11种心血管疾病类型进行分析的108篇文章(21166名患者)中,通过未经出版偏倚调整的贝叶斯模型平均荟萃分析评估的RVEF降低5%的集合HR为所有类型心血管疾病的预后提供了中度或强有力的相关证据(HR:1.07-1.37,BF10:4.3-9.6*107)。与此相反,一项稳健的贝叶斯模型平均荟萃分析在对发表偏倚进行调整后发现,有中度或强有力的证据表明,RVEF仅与肥厚型心肌病的预后有关(HR:1.19,95% CrI:0.98-1.42,BF10:5.0)、扩张型心肌病(HR:1.16,95% CrI:1-1.22,BF10:23.3)、肺动脉高压(HR:1.05,95% CrI:1-1.12,BF10:3.0)和主动脉瓣狭窄(HR:1.15,95% CrI:0.97-1.34,BF10:4.2)。在其他七种心血管疾病中,RVEF与不良预后相关的证据不足:结论:在贝叶斯荟萃分析中,根据发表偏倚进行调整后,只有四种心血管疾病的RVEF与预后存在中度或强力相关证据。其他数据可能会加强其他心血管疾病的证据。
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Impact of Cardiac Magnetic Resonance-Derived Right Ventricular Ejection Fraction on Adverse Outcomes: A Robust Bayesian Model-Averaged Meta-Analysis.

Background: There are few meta-analyses examining the prognostic value of right ventricular ejection fraction (RVEF) for a specific type of cardiovascular disease (CVD). The aim of this study was to compare the association of cardiac magnetic resonance (CMR)-derived RVEF with adverse outcomes for several specific types of CVD, using a robust Bayesian model-averaged meta-analysis.

Methods: Three databases were searched for CMR articles reporting hazard ratios (HRs) of RVEF restricted to a specific type of CVD. For each specific type of CVD, Bayesian model-averaged meta-analyses with and without publication bias adjustments were conducted to evaluate the strength of evidence for RVEF according to the Bayes Factor (BF).

Results: Among 108 articles (21,166 patients) analyzing 11 CVD types, pooled HR for 5% reduction in RVEF assessed by publication bias-unadjusted, Bayesian model-averaged meta-analysis offered moderate or strong evidence of an association with outcomes for all types of CVD (HR: 1.07-1.37, BF10: 4.3-9.6*107). In contrast, a robust Bayesian model-averaged meta-analysis, adjusted for publication bias, found moderate or strong evidence in favor of an association of RVEF with outcomes only in hypertrophic cardiomyopathy (HR: 1.19, 95% CrI: 0.98-1.42, BF10: 5.0), dilated cardiomyopathy (HR: 1.16, 95% CrI: 1-1.22, BF10: 23.3), pulmonary hypertension (HR: 1.05, 95% CrI: 1-1.12, BF10: 3.0), and aortic stenosis (HR: 1.15, 95% CrI: 0.97-1.34, BF10: 4.2). There was weak evidence for an association of RVEF with adverse outcomes in seven other CVDs.

Conclusions: In a Bayesian meta-analysis adjusted for publication bias, there was moderate or strong evidence for an association of RVEF with outcomes for only four CVDs. Additional data may strengthen evidence regarding other CVDs.

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来源期刊
CiteScore
10.90
自引率
12.50%
发文量
61
审稿时长
6-12 weeks
期刊介绍: Journal of Cardiovascular Magnetic Resonance (JCMR) publishes high-quality articles on all aspects of basic, translational and clinical research on the design, development, manufacture, and evaluation of cardiovascular magnetic resonance (CMR) methods applied to the cardiovascular system. Topical areas include, but are not limited to: New applications of magnetic resonance to improve the diagnostic strategies, risk stratification, characterization and management of diseases affecting the cardiovascular system. New methods to enhance or accelerate image acquisition and data analysis. Results of multicenter, or larger single-center studies that provide insight into the utility of CMR. Basic biological perceptions derived by CMR methods.
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