Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review.
Imaging Biomarkers and Prevalence of Complex Aortic Plaque in Cryptogenic Stroke: A Systematic Review.
复制标题
DOI：
10.1161/jaha.123.031797
复制
发表时间：
2023-12-05
影响因子：
5.4
通讯作者：
中科院分区：
文献类型：
--
作者：
复杂性主动脉斑块（CAP）是隐源性卒中（CS）患者的潜在栓塞源。我们回顾了经食管超声心动图（TEE）、计算机断层扫描血管造影（CTA）和磁共振成像的CAP成像标准，并计算急性CS患者的CAP患病率。根据系统性综述和Meta-分析的首选报告项目指南，检索了截至2022年12月的PubMed和EMBASE数据库。两名独立的审查员提取了研究设计、成像技术、CAP标准和患病率的数据。分别使用科克伦协作工具和报告可靠性和一致性研究指南评估偏倚风险和报告完整性。在2293项研究中，审查了45项急性CS患者的CAP成像生物标志物标准（N=37 TEE; N=9 CTA; N=6磁共振成像）。大多数研究（74%）使用≥4 mm斑块厚度作为CAP的成像标准，尽管也报告了≥1 mm（N=1，CTA）、≥5 mm（N=5，TEE）和≥6 mm（N=2，CTA）。其他特征包括移动性、溃疡、血栓、突起和斑块组成评估。在23项前瞻性研究中，2778例CS患者中有960例检测到CAP（0.32 [95%CI，0.24-0.41]，I2 =94%）。根据方式，TEE的患病率估计值为0.29（95% CI，0.20-0.40; I2 =95%）; CTA为0.23（95% CI，0.15-0.34; I2 =87%），磁共振成像为0.22（95% CI，0.06-0.54; I2 =92%）。TEE常用于评估CS患者的CAP。最常见的CAP成像生物标志物为斑块厚度≥4 mm。在三分之一的急性CS患者中观察到CAP。然而，高研究异质性表明需要可重复的成像方法。
Complex aortic plaque (CAP) is a potential embolic source in patients with cryptogenic stroke (CS). We review CAP imaging criteria for transesophageal echocardiogram (TEE), computed tomography angiography (CTA), and magnetic resonance imaging and calculate CAP prevalence in patients with acute CS. PubMed and EMBASE databases were searched up to December 2022 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. Two independent reviewers extracted data on study design, imaging techniques, CAP criteria, and prevalence. The Cochrane Collaboration tool and Guideline for Reporting Reliability and Agreement Studies were used to assess risk of bias and reporting completeness, respectively. From 2293 studies, 45 were reviewed for CAP imaging biomarker criteria in patients with acute CS (N=37 TEE; N=9 CTA; N=6 magnetic resonance imaging). Most studies (74%) used ≥4 mm plaque thickness as the imaging criterion for CAP although ≥1 mm (N=1, CTA), ≥5 mm (N=5, TEE), and ≥6 mm (N=2, CTA) were also reported. Additional features included mobility, ulceration, thrombus, protrusions, and assessment of plaque composition. From 23 prospective studies, CAP was detected in 960 of 2778 patients with CS (0.32 [95% CI, 0.24–0.41], I 2=94%). By modality, prevalence estimates were 0.29 (95% CI, 0.20–0.40; I 2=95%) for TEE; 0.23 (95% CI, 0.15–0.34; I 2=87%) for CTA and 0.22 (95% CI, 0.06–0.54; I 2=92%) for magnetic resonance imaging. TEE was commonly used to assess CAP in patients with CS. The most common CAP imaging biomarker was ≥4 mm plaque thickness. CAP was observed in one‐third of patients with acute CS. However, high study heterogeneity suggests a need for reproducible imaging methods.
影响因子：
3.3
作者：
Hu Z;Christodoulou AG;Wang N;Shaw JL;Song SS;Maya MM;Ishimori ML;Forbess LJ;Xiao J;Bi X;Han F;Li D;Fan Z
通讯作者：
Fan Z
影响因子：
3.4
作者：
Strecker C;Günther F;Harloff A
通讯作者：
Harloff A
影响因子：
1.9
作者：
Abe A;Harada-Abe M;Ueda M;Katano T;Nakajima M;Muraga K;Suda S;Nishiyama Y;Okubo S;Mishina M;Katsura K;Katayama Y
通讯作者：
Katayama Y