三维斑点追踪成像应变参数对检测癌症化疗相关心功能障碍的诊断价值：一项荟萃分析。
Diagnostic Value of Three-Dimensional Speckle Tracking Imaging Strain Parameters for Detection of Cancer Chemotherapy-Related Cardiac Dysfunction: A Meta-Analysis.
机构信息
Taizhou Central Hospital (Taizhou University Hospital), Taizhou - China.
出版信息
Arq Bras Cardiol. 2023 Jul;120(8):e20220370. doi: 10.36660/abc.20220370.
BACKGROUND
Chemotherapeutic agents (e.g., anthracyclines, trastuzumab) commonly used for treating malignant tumors have been demonstrated to have cardiotoxic effects, which is associated with poor prognosis. Three-dimensional echocardiography has been used to predict cancer chemotherapy-induced cardiac dysfunction.
OBJECTIVES
Evaluation of the diagnostic performance of strain parameters, global area strain (GAS), longitudinal strain (GLS), circumferential strain (GCS), and radial strain (GRS) by meta-analysis.
METHODS
Relevant studies were searched from the Embase, PubMed, and Web of Science databases. Statistical analysis was performed using Stata 12. The summary receiver operating characteristic curve, sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and corresponding 95% confidence interval for the four strain parameters were pooled. P<0.05 was considered statistically significant.
RESULTS
Nine studies involving 650 participants were included. GAS and GLS showed significant diagnostic advantages over GCS and GRS. For GAS, the sensitivity was 0.85 (0.70, 0.93) and specificity was 0.82(0.78, 0.86) with PLR of 4.76 (3.55, 6.39) and NLR of 0.18 (0.09, 0.39) and an area under the curve (AUC) of 0.85 (0.82, 0.88). For GLS, the sensitivity was 0.81 (0.74, 0.86) and specificity was 0.81(0.68, 0.90) with PLR of 4.35(2.42, 7.80) and NLR of 0.23 (0.17, 0.33) and an AUC of 0.85 (0.82, 0.88). The GCS showed a sensitivity of 0.63 and a specificity of 0.79 with an AUC of 0.77. The GRS showed a sensitivity of 0.74 and a specificity of 0.66 with an AUC of 0.73.
CONCLUSION
3D-STI strain parameters GAS and GLS showed good performance in detecting early cardiac dysfunction in patients with tumors receiving chemotherapy.
背景
用于治疗恶性肿瘤的化疗药物（例如蒽环类药物、曲妥珠单抗）已被证明具有心脏毒性作用，这与预后不良有关。三维超声心动图已被用于预测癌症化疗引起的心脏功能障碍。
目的
通过荟萃分析评估应变参数、整体面积应变（GAS）、纵向应变（GLS）、周向应变（GCS）和径向应变（GRS）的诊断性能。
方法
从 Embase、PubMed 和 Web of Science 数据库中搜索相关研究。使用 Stata 12 进行统计分析。汇总受试者工作特征曲线、敏感度、特异度、阳性似然比（PLR）、阴性似然比（NLR）和四个应变参数的相应 95%置信区间。P<0.05 被认为具有统计学意义。
结果
纳入了 9 项涉及 650 名参与者的研究。GAS 和 GLS 比 GCS 和 GRS 具有更显著的诊断优势。对于 GAS，敏感度为 0.85（0.70，0.93），特异度为 0.82（0.78，0.86），阳性似然比为 4.76（3.55，6.39），阴性似然比为 0.18（0.09，0.39），曲线下面积（AUC）为 0.85（0.82，0.88）。对于 GLS，敏感度为 0.81（0.74，0.86），特异度为 0.81（0.68，0.90），阳性似然比为 4.35（2.42，7.80），阴性似然比为 0.23（0.17，0.33），AUC 为 0.85（0.82，0.88）。GCS 的敏感度为 0.63，特异度为 0.79，AUC 为 0.77。GRS 的敏感度为 0.74，特异度为 0.66，AUC 为 0.73。
结论
3D-STI 应变参数 GAS 和 GLS 在检测接受化疗的肿瘤患者早期心脏功能障碍方面表现良好。
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