Department of Radiology, Shengjing Hospital of China Medical University, No. 36, Sanhao Street, Heping District, Shenyang, 110004, China.
Eur Radiol. 2021 Jul;31(7):4528-4537. doi: 10.1007/s00330-020-07437-w. Epub 2021 Jan 7.
Cardiac magnetic resonance imaging (CMR) has proven itself as an accurate and robust diagnostic approach and has been widely used in the detection of various heart diseases. An increasing number of studies focusing more on the prognostic aspect of LGE-CMR arose in recent years, contributing to the redundant systematic reviews and meta-analyses in this field. By providing a bird's eye view and performing scrupulous evidence rating, this umbrella review aims to help clinical practitioners and policy-makers interpret the results of the meta-analyses on the prognostic role of late gadolinium enhancement (LGE) in patients with heart diseases.
An umbrella review of meta-analyses of observational studies.
The 11 included systematic reviews comprise 33 meta-analyses covering 11 types of heart diseases, 19 different outcomes, 23,058 subjects, and 5393 events. Thirty-one of 33 meta-analyses were found supported by weak pieces of evidence and the remaining were deemed not suggestive. The meta-analysis with a p value of 9.21 × 10 and 991 events was updated by strictly re-conducting the meta-analysis by Becker et al. The updated meta-analysis on the prognostic role of LGE in subjects with non-ischemic dilated cardiomyopathy (DCM) in terms of major adverse cardiovascular events (MACE) included 1131 events and was rated as highly suggestive evidence.
The prognostic role of LGE in DCM patients in terms of MACE is supported by highly suggestive evidence, which may facilitate the optimization of the timing of prophylactic implantable or wearable implantable cardioverter-defibrillators (ICD) considering the high risk of MACE and lower expectation of recovery.
• Cardiac magnetic resonance imaging (CMR) has been widely used in the detection of various heart diseases. Numerous studies focusing on the prognostic aspect of LGE arose in recent years. • The meta-analysis on the prognostic role of LGE in dilated cardiomyopathy (DCM) patients in terms of major adverse cardiovascular events (MACE) by Becker et al was updated and was deemed to be supported by highly suggestive evidence. • The credibility of the meta-analysis supported by highly suggestive evidence may facilitate the optimization of the timing of prophylactic implantable or wearable implantable cardioverter defibrillators (ICD) considering the high risk of MACE and lower expectation of recovery.
心脏磁共振成像（CMR）已被证明是一种准确而强大的诊断方法，并已广泛用于各种心脏病的检测。近年来，越来越多的研究侧重于 LGE-CMR 的预后方面，这导致了该领域大量重复的系统评价和荟萃分析。通过提供全局视角并进行严格的证据评估，本综述旨在帮助临床医生和决策者解释关于心脏疾病患者 LGE 预后作用的荟萃分析结果。
对观察性研究的荟萃分析进行伞式综述。
纳入的 11 项系统评价综述涵盖了 11 种心脏病、19 种不同结局、23058 名受试者和 5393 例事件的 33 项荟萃分析。33 项荟萃分析中有 31 项被认为证据较弱，其余则不具有提示作用。Becker 等人严格重新进行荟萃分析后更新了 p 值为 9.21×10-9 和 991 例事件的荟萃分析。更新后的 LGE 在非缺血性扩张型心肌病（DCM）患者中的预后作用的荟萃分析，包含 1131 例事件，被认为具有高度提示性证据。
DCM 患者中 LGE 在重大不良心血管事件（MACE）方面的预后作用具有高度提示性证据，这可能有助于优化预防性植入式或可穿戴式植入式心脏复律除颤器（ICD）的时机，因为 MACE 风险高且恢复预期较低。
心脏磁共振成像（CMR）已广泛用于各种心脏病的检测。近年来，出现了许多侧重于 LGE 预后方面的研究。
Becker 等人更新了 LGE 在扩张型心肌病（DCM）患者中的预后作用的荟萃分析，认为该分析具有高度提示性证据支持。
具有高度提示性证据支持的荟萃分析的可信度可能有助于优化预防性植入式或可穿戴式植入式心脏复律除颤器（ICD）的时机，因为 MACE 风险高且恢复预期较低。
