Agarwal Rajender, Gosain Priyanka, Kirkpatrick James N, Alyousef Tareq, Doukky Rami, Singh Gurpreet, Umscheid Craig A
Department of Medicine, John H Stroger Jr Hospital of Cook County, Chicago, IL, USA.
Cardiovasc Ultrasound. 2012 Nov 30;10:47. doi: 10.1186/1476-7120-10-47.
Global and regional left ventricular (LV) systolic dysfunction is a marker of coronary artery disease (CAD), which is conventionally assessed using two-dimensional echocardiography. Tissue Doppler imaging (TDI) has emerged as an adjunct tool in the diagnosis of regional wall motion abnormalities from CAD. We performed a systematic review and meta-analysis to assess the efficacy of TDI indices in the diagnosis of CAD. We searched MEDLINE and the Cochrane Library for controlled studies comparing TDI measurements in those with and without CAD as confirmed by coronary angiography. Meta-analyses of mean differences in TDI velocities between these populations were performed. Screening of titles and abstracts followed by full-text screening identified 8 studies. At rest, TDI was associated with a significant decrease in the pooled maximum systolic velocity among CAD patients compared to those without CAD [mean difference (MD): -0.66; 95% confidence interval (CI): -0.98 to -0.34]. There were no significant differences in maximum early and late diastolic velocities. Post-stress, TDI was associated with a significant decrease in maximum early diastolic velocity (MD: -1.91; 95% CI: -2.74 to -1.09) and maximum late diastolic velocity (MD: -1.57; 95% CI: -2.95 to -0.18) among CAD patients compared to those without CAD. There was no significant difference in maximum systolic velocity post-stress. Our results suggest that TDI may have a role in the evaluation of CAD. Future studies should evaluate the incremental value of TDI velocities over LV ejection fraction and two dimensional wall motion analysis in the detection of CAD and assessment of its severity. (Word Count: 249).
全球及区域性左心室（LV）收缩功能障碍是冠状动脉疾病（CAD）的一个标志，传统上使用二维超声心动图进行评估。组织多普勒成像（TDI）已成为诊断CAD所致局部室壁运动异常的辅助工具。我们进行了一项系统综述和荟萃分析，以评估TDI指标在CAD诊断中的疗效。我们在MEDLINE和Cochrane图书馆中检索了对照研究，比较经冠状动脉造影证实患有和未患有CAD者的TDI测量值。对这些人群之间TDI速度的平均差异进行了荟萃分析。通过标题和摘要筛选，随后进行全文筛选，确定了8项研究。静息时，与未患CAD者相比，CAD患者中TDI与汇总的最大收缩速度显著降低相关[平均差异（MD）：-0.66；95%置信区间（CI）：-0.98至-0.34]。最大舒张早期和晚期速度无显著差异。应激后，与未患CAD者相比，CAD患者中TDI与最大舒张早期速度显著降低（MD：-1.91；。95%CI：-2.74至-1.09）和最大舒张晚期速度显著降低（MD：-1.57；。95%CI：-2.95至-0.18）相关。应激后最大收缩速度无显著差异。我们的结果表明，TDI可能在CAD评估中发挥作用。未来的研究应评估TDI速度相对于左心室射血分数和二维室壁运动分析在CAD检测及其严重程度评估中的增量价值。（字数：249）
