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Evaluation of aortic valve stenosis by cardiac multislice computed tomography compared with echocardiography: a systematic review and meta-analysis


Abdulla, Jawdat; Sivertsen, Jacob; Kofoed, Klaus Fuglsang; Alkadhi, Hatem; LaBounty, Troy; Abildstrom, Steen Z; Kober, Lars; Christensen, Erik; Torp-Pedersen, Christian (2009). Evaluation of aortic valve stenosis by cardiac multislice computed tomography compared with echocardiography: a systematic review and meta-analysis. Journal of Heart Valve Disease, 18(6):634-643.

Abstract

BACKGROUND AND AIM OF THE STUDY It has not yet been established whether multi-slice computed tomography (MSCT) is reliable for the quantification of aortic valve area (AVA) in patients with aortic valve stenosis (AVS) and simultaneously for assessment of the coronary anatomy. The study aim, via a systematic literature review and meta-analysis, was to explore whether MSCT is a reliable method for AVA quantification, and simultaneously to assess the coronary anatomy in patients with AVS. METHODS A comprehensive systematic literature search and meta-analysis was conducted that included 14 studies totaling 470 patients. The meta-analysis was carried out to examine the reliability of MSCT compared to transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Seven studies including 266 patients with AVS were also eligible for a secondary analysis to compare the accuracy of MSCT with invasive coronary angiography. RESULTS The AVA was measured by MSCT and TTE in all 14 studies, and by TEE in four studies. The results of the meta-analyses showed that planimetry by MSCT overestimated the AVA, with a bias of 0.08 (95% CI 0.04, 0.13) cm2) (p = 0.0001) compared to TTE. The MSCT measurement was concordant with planimetry by TEE, with a small bias of -0.02 (95% CI -0.16, 0.11) cm2 (p = 0.71). MSCT, when compared to invasive angiography for the detection of significant coronary stenosis, showed sensitivity, specificity and diagnostic odds ratio of 95.5% (95% CI 88-99), 81% (95% CI 75-86)%, and 53 (95% CI 19-147), respectively. CONCLUSION MSCT is a reliable method for the quantification of AVA, and represents a promising technique for the combined evaluation of aortic valve morphology and coronary artery disease.

Abstract

BACKGROUND AND AIM OF THE STUDY It has not yet been established whether multi-slice computed tomography (MSCT) is reliable for the quantification of aortic valve area (AVA) in patients with aortic valve stenosis (AVS) and simultaneously for assessment of the coronary anatomy. The study aim, via a systematic literature review and meta-analysis, was to explore whether MSCT is a reliable method for AVA quantification, and simultaneously to assess the coronary anatomy in patients with AVS. METHODS A comprehensive systematic literature search and meta-analysis was conducted that included 14 studies totaling 470 patients. The meta-analysis was carried out to examine the reliability of MSCT compared to transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Seven studies including 266 patients with AVS were also eligible for a secondary analysis to compare the accuracy of MSCT with invasive coronary angiography. RESULTS The AVA was measured by MSCT and TTE in all 14 studies, and by TEE in four studies. The results of the meta-analyses showed that planimetry by MSCT overestimated the AVA, with a bias of 0.08 (95% CI 0.04, 0.13) cm2) (p = 0.0001) compared to TTE. The MSCT measurement was concordant with planimetry by TEE, with a small bias of -0.02 (95% CI -0.16, 0.11) cm2 (p = 0.71). MSCT, when compared to invasive angiography for the detection of significant coronary stenosis, showed sensitivity, specificity and diagnostic odds ratio of 95.5% (95% CI 88-99), 81% (95% CI 75-86)%, and 53 (95% CI 19-147), respectively. CONCLUSION MSCT is a reliable method for the quantification of AVA, and represents a promising technique for the combined evaluation of aortic valve morphology and coronary artery disease.

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20 citations in Web of Science®
25 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:November 2009
Deposited On:16 Aug 2016 09:16
Last Modified:16 Aug 2016 09:16
Publisher:ICR Publishers
ISSN:0966-8519
Official URL:http://www.icr-heart.com/?cid=2153
PubMed ID:20099712

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