Clinical outcomes meta-analysis: measuring subendocardial perfusion and efficacy of transmyocardial laser revascularization with nuclear imaging

Journal of Cardiothoracic Surgery
Jessika IwanskiZain Khalpey

Abstract

Randomized and nonrandomized clinical trials have tried to assess whether or not TMR patients experience an increase in myocardial perfusion. However there have been inconsistencies reported in the literature due to the use of different nuclear imaging modalities to test this metric. The primary purpose of this meta-analysis was to determine whether SPECT, MUGA and PET scans demonstrate changes in myocardial perfusion between lased and non-lased subjects and whether laser type affects myocardial perfusion. The secondary purpose was to examine the overall effect of laser therapy on clinical outcomes including survival, hospital re-admission and angina reduction. Sixteen studies were included in the primary endpoint analysis after excluding all other non-imaging TMR papers. Standardized mean difference was used as the effect size for all quantitative outcomes and log odds ratio was used as the effect size for all binary outcomes. Statistically significant improvements in myocardial perfusion were observed between control and treatment groups in myocardial perfusion at 6-month follow up using PET imaging with a porcine model. However non-significant differences were observed in patients at 3 and 12 months using SPECT, PET or MUGA ...Continue Reading

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Citations

Dec 1, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Ryan J AveryZain I Khalpey

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Methods Mentioned

BETA
coronary artery bypass
imaging techniques

Software Mentioned

MUGA
Program
OvidSP
ScienceDirect
EBSCOHost
R package ‘ metafor ’
R
R package ‘ MAd ’
MEDLINE
PUBMED

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