Superior prognostic value of three-dimensional echocardiography-derived right ventricular ejection fraction: a meta-analysis
ABSTRACT Aims We aimed to confirm that three-dimensional echocardiography (3DE)-derived right ventricular (RV) ejection fraction (EF) is a more robust predictor of adverse cardiopulmonary outcomes than the conventional echocardiographic parameters.Methods and Results We performed a meta-analysis of studies reporting the impact of unit change of RVEF, tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and free-wall longitudinal strain (FWLS) on clinical outcomes (all-cause mortality and/or adverse cardiopulmonary outcomes). Hazard ratios (HR) were rescaled by the within-study standard deviations (SD) to represent standardized changes. Within each study, we calculated the ratio of HRs related to 1 SD reduction in RVEF versus TAPSE, or FAC, or FWLS, to quantify the predictive value of RVEF relative to the other metrics. These ratios of HRs were pooled using random-effects models.Ten independent studies were identified as suitable, including data on 1,928 patients with various cardiopulmonary conditions. Overall, 1 SD reduction in RVEF was robustly associated with adverse outcomes (HR: 2.64 [95% CI: 2.18 to 3.20], p<0.001; heterogeneity: I2=65%, p=0.002). In studies reporting HRs for RVEF and TAPSE, FAC, or FWLS in the same cohort, RVEF had superior predictive value per SD reduction versus the other three parameters (vs. TAPSE, HR: 1.54 [95% CI: 1.04 to 2.28], p=0.031; vs. FAC, HR: 1.45 [95% CI: 1.15 to 1.81], p=0.001; vs. FWLS, HR: 1.44 [95% CI: 1.07 to 1.95], p=0.018).Conclusion 3DE-derived RVEF has superior prognostic value compared with conventional RV indices, therefore, it might further refine the risk stratification of patients with cardiopulmonary diseases.Graphical Abstract Added predictive value of three-dimensional (3D) echocardiography-derived right ventricular ejection fraction (RVEF) versus conventional metrics of RV systolic function on clinical outcomes: a meta-analysis of 10 studies. FAC: fractional area change, FWLS: free-wall longitudinal strain, HR: hazard ratio, SD: standard deviation, TAPSE: tricuspid annular plane systolic excursion<jats:fig id="ufig1" position="float" fig-type="figure" orientation="portrait"><jats:graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="22275907v2_ufig1" position="float" orientation="portrait" /></jats:fig>.
| Medienart: |
|
|---|
Preprint| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
bioRxiv.org - (2024) vom: 23. Apr. Zur Gesamtaufnahme - year:2024 |
|---|
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Sayour, Alex Ali [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
|---|
| doi: |
10.1101/2022.06.02.22275907 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
XBI036184209 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | XBI036184209 | ||
| 003 | DE-627 | ||
| 005 | 20240425104519.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 220604s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1101/2022.06.02.22275907 |2 doi | |
| 035 | |a (DE-627)XBI036184209 | ||
| 035 | |a (biorXiv)10.1101/2022.06.02.22275907 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Sayour, Alex Ali |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Superior prognostic value of three-dimensional echocardiography-derived right ventricular ejection fraction: a meta-analysis |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a ABSTRACT Aims We aimed to confirm that three-dimensional echocardiography (3DE)-derived right ventricular (RV) ejection fraction (EF) is a more robust predictor of adverse cardiopulmonary outcomes than the conventional echocardiographic parameters.Methods and Results We performed a meta-analysis of studies reporting the impact of unit change of RVEF, tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC), and free-wall longitudinal strain (FWLS) on clinical outcomes (all-cause mortality and/or adverse cardiopulmonary outcomes). Hazard ratios (HR) were rescaled by the within-study standard deviations (SD) to represent standardized changes. Within each study, we calculated the ratio of HRs related to 1 SD reduction in RVEF versus TAPSE, or FAC, or FWLS, to quantify the predictive value of RVEF relative to the other metrics. These ratios of HRs were pooled using random-effects models.Ten independent studies were identified as suitable, including data on 1,928 patients with various cardiopulmonary conditions. Overall, 1 SD reduction in RVEF was robustly associated with adverse outcomes (HR: 2.64 [95% CI: 2.18 to 3.20], p<0.001; heterogeneity: I2=65%, p=0.002). In studies reporting HRs for RVEF and TAPSE, FAC, or FWLS in the same cohort, RVEF had superior predictive value per SD reduction versus the other three parameters (vs. TAPSE, HR: 1.54 [95% CI: 1.04 to 2.28], p=0.031; vs. FAC, HR: 1.45 [95% CI: 1.15 to 1.81], p=0.001; vs. FWLS, HR: 1.44 [95% CI: 1.07 to 1.95], p=0.018).Conclusion 3DE-derived RVEF has superior prognostic value compared with conventional RV indices, therefore, it might further refine the risk stratification of patients with cardiopulmonary diseases.Graphical Abstract Added predictive value of three-dimensional (3D) echocardiography-derived right ventricular ejection fraction (RVEF) versus conventional metrics of RV systolic function on clinical outcomes: a meta-analysis of 10 studies. FAC: fractional area change, FWLS: free-wall longitudinal strain, HR: hazard ratio, SD: standard deviation, TAPSE: tricuspid annular plane systolic excursion<jats:fig id="ufig1" position="float" fig-type="figure" orientation="portrait"><jats:graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="22275907v2_ufig1" position="float" orientation="portrait" /></jats:fig> | ||
| 650 | 4 | |a Biology |7 (dpeaa)DE-84 | |
| 650 | 4 | |a 570 |7 (dpeaa)DE-84 | |
| 700 | 1 | |a Tokodi, Márton |e verfasserin |4 aut | |
| 700 | 1 | |a Celeng, Csilla |e verfasserin |4 aut | |
| 700 | 1 | |a Takx, Richard A. P. |e verfasserin |4 aut | |
| 700 | 1 | |a Fábián, Alexandra |e verfasserin |4 aut | |
| 700 | 1 | |a Lakatos, Bálint K. |e verfasserin |4 aut | |
| 700 | 1 | |a Friebel, Rocco |e verfasserin |4 aut | |
| 700 | 1 | |a Surkova, Elena |e verfasserin |4 aut | |
| 700 | 1 | |a Merkely, Béla |e verfasserin |4 aut | |
| 700 | 1 | |a Kovács, Attila |e verfasserin |0 (orcid)0000-0003-2320-6434 |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t bioRxiv.org |g (2024) vom: 23. Apr. |
| 773 | 1 | 8 | |g year:2024 |g day:23 |g month:04 |
| 856 | 4 | 0 | |u https://doi.org/10.1016/j.echo.2023.01.018 |x 0 |z lizenzpflichtig |3 Volltext |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1101/2022.06.02.22275907 |x 0 |z kostenfrei |3 Volltext |
| 912 | |a GBV_XBI | ||
| 951 | |a AR | ||
| 952 | |j 2024 |b 23 |c 04 | ||