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Title: | Diagnostic accuracy of inferior vena cava ultrasound for heart failure in patients with acute dyspnoea : a systematic review and meta-analysis |
Authors: | Squizzato, Alessandro Maroni, Lorenzo Marrazzo, Cristina Riva, Nicoletta Guasti, Luigina |
Keywords: | Systematic reviews (Medical research) Blood -- Coagulation Cardiovascular system -- Diseases Thrombosis -- Diagnosis Thromboembolism -- Diagnosis |
Issue Date: | 2021 |
Publisher: | BMJ |
Citation: | Squizzato, A., Maroni, L., Marrazzo, C., Riva, N., & Guasti, L. (2021). Diagnostic accuracy of inferior vena cava ultrasound for heart failure in patients with acute dyspnoea: a systematic review and meta-analysis. Emergency Medicine Journal, 38(3), 232-239. |
Abstract: | Background: Dyspnoea is the most common sign of heart failure (HF). Patients accessing the ED for HF-related symptoms require fast diagnosis and early treatment. Transthoracic echocardiography has a crucial role in HF diagnosis, but requires qualified staff and adequate time for execution. The measurement of inferior vena cava (IVC) diameter has been recently proposed as a rapid, simple and reliable marker of volume overload. The aim of this systematic review was to assess the accuracy of IVC-ultrasound as a stand-alone test for HF diagnosis in patients presenting to the ED with acute dyspnoea. Methods: Studies evaluating the diagnostic accuracy of the inferior vena cava collapsibility index (IVC-CIx) for HF diagnosis were systematically searched in the EMBASE and MEDLINE databases (up to January 2018). Quality Assessment of Diagnostic Accuracy Studies 2 tool was used for the quality assessment of the primary studies. A bivariate random-effects regression approach was used for summary estimates of both sensitivity and specificity. Results: Seven studies, for a total of 591 patients, were included. Three studies were at low-risk of bias. All studies used a proper reference test. Weighted mean prevalence of HF was 49.3% at random-effect model (I2 index for heterogeneity=74.7%). IVC-CIx bivariate weighted mean sensitivity was 79.1% (95% CI 68.5% to 86.8%) and bivariate weighted mean specificity was 81.8% (95% CI 75.0% to 87.0%). Conclusions: Our findings suggest that the sensitivity and specificity of IVC-CIx are suboptimal to rule in or rule out HF diagnosis in patients with acute dyspnoea in the ED setting. Therefore, IVC-CIx is not advisable as a stand-alone test, but may be useful when integrated in a specific diagnostic algorithm for the differential diagnosis of acute dyspnoea. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/88397 |
Appears in Collections: | Scholarly Works - FacM&SPat |
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Diagnostic accuracy of inferior vena cava ultrasound for heart failure in patients with acute dyspnoea .pdf Restricted Access | 1.49 MB | Adobe PDF | View/Open Request a copy |
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