Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website http://www.cardiologyres.org

Original Article

Volume 11, Number 3, June 2020, pages 145-154

Diagnostic Accuracy of Cardiac Magnetic Resonance Versus Fractional Flow Reserve: A Systematic Review and Meta-Analysis

Figures

Figure 1.
Figure 1. Overall risk of bias on the QUADAS-2 tool of the included studies in our study. QUADAS-2: the Quality Assessment of Diagnostic Accuracy Studies.
Figure 2.
Figure 2. Risk of bias on the QUADAS-2 tool of the individual studies included in our meta-analysis. QUADAS-2: the Quality Assessment of Diagnostic Accuracy Studies.
Figure 3.
Figure 3. PRISMA flow diagram showing the selection of studies from all databases. PRISMA: preferred reporting items for systematic review and meta-analysis.
Figure 4.
Figure 4. (a) Forest plot depicting individual and pooled sensitivity at the patient level. (b) Forest plot depicting individual and pooled specificity at the patient level.
Figure 5.
Figure 5. Patient-level pooled diagnostic accuracy of CMR associated HROC vessel. CMR: cardiac magnetic resonance; HROC: hierarchical summary receiver operating characteristic.
Figure 6.
Figure 6. (a) Forest plot depicting individual and pooled sensitivity at the vessel level. (b) Forest plot depicting individual and pooled specificity at the vessel level.
Figure 7.
Figure 7. Vessel-level pooled diagnostic accuracy of CMR associated HROC. CMR: cardiac magnetic resonance; HROC: hierarchical summary receiver operating characteristic.

Tables

Table 1. Meta-Regression Analysis on the Basis of CAD Prevalence and Age of the Patients in Included Studies
 
VariableSensitivity (95% CI)Specificity (95% CI)DOR
CAD: coronary artery disease; MI: myocardial infarction; 95% CI: 95% confidence interval; DOR: diagnostic odds ratio.
Vessel level, MI > 60%0.84 (0.77 - 0.88)0.86 (0.81 - 0.89)32 (19 - 53)
Patient, MI > 60%0.92 (0.88 - 0.94)0.94 (0.92 - 0.96)12 (10 - 33)
Vessel level, MI < 60%0.81 (0.66 - 0.91)0.88 (0.82 - 0.92)34 (14 - 80)
Patient, MI < 60%0.82 (0.74 - 0.89)0.84 (0.81 - 0.87)27 (15 - 50)
Vessel level, Age < 650.82 (0.74 - 0.88)0.89 (0.85 - 0.92)34 (14 - 80)
Patient, Age < 650.86 (0.79 - 0.91)0.89 (0.85 - 0.93)58 (26 - 126)
Vessel level, Age > 650.86 (0.71 - 0.94)0.81 (0.72 - 0.88)28 (12 - 67)

 

Table 2. Characteristics, Outcomes and Limitations of Previously Reported Meta-Analyses
 
AuthorStudies includedSensitivity, specificityLimitation
Patient levelVessel level
CAD: coronary artery disease.
Desai et al, 2013 [33]1289.1%, 84.9%87.7%, 88.6%Used 0.75 only
Li et al, 2014 [34]1490%, 87%89%, 86%No stratification based on thresholds
Jiang et al, 2016 [35]2088%, 88%86%, 88%No stratification based on thresholds
Danad et al, 2017 [36]490%, 94%91%, 85%No stratification based on thresholds
Dai et al, 2016 [37]2188%, 84%87%, 89%No stratification based on MRI thresholds
Yang et al, 2019 [2]1987%, 87%85%, 89%CAD 50-75%