Journal of Cardiovascular Magnetic Resonance (Jan 2024)

Impact of cardiovascular magnetic resonance-derived right ventricular ejection fraction on adverse outcomes: A robust Bayesian model-averaged meta-analysis

  • Tetsuji Kitano,
  • František Bartoš,
  • Yosuke Nabeshima,
  • Alex Ali Sayour,
  • Attila Kovács,
  • Masaaki Takeuchi

Journal volume & issue
Vol. 26, no. 2
p. 101118

Abstract

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ABSTRACT: Background: There are few meta-analyses examining the prognostic value of right ventricular ejection fraction (RVEF) for a specific type of cardiovascular disease (CVD). The aim of this study was to compare the association of cardiac magnetic resonance (CMR)-derived RVEF with adverse outcomes for several specific types of CVD, using a robust Bayesian model-averaged meta-analysis. Methods: Three databases were searched for CMR articles reporting hazard ratios (HRs) of RVEF restricted to a specific type of CVD. For each specific type of CVD, Bayesian model-averaged meta-analyses with and without publication bias adjustments were conducted to evaluate the strength of evidence for RVEF according to the Bayes factor (BF). Results: Among 108 articles (21,166 patients) analyzing 11 CVD types, pooled HR for 5% reduction in RVEF assessed by publication bias-unadjusted, Bayesian model-averaged meta-analysis offered moderate or strong evidence of an association with outcomes for all types of CVD (HR: 1.07–1.37, BF10: 4.3–9.6 * 107). In contrast, a robust Bayesian model-averaged meta-analysis, adjusted for publication bias, found moderate or strong evidence in favor of an association of RVEF with outcomes only in hypertrophic cardiomyopathy (HR: 1.19, 95% credible interval (CrI): 0.98–1.42, BF10: 5.0), dilated cardiomyopathy (HR: 1.16, 95% CrI: 1–1.22, BF10: 23.3), pulmonary hypertension (HR: 1.05, 95% CrI: 1–1.12, BF10: 3.0), and aortic stenosis (HR: 1.15, 95% CrI: 0.97–1.34, BF10: 4.2). There was weak evidence for an association of RVEF with adverse outcomes in seven other CVDs. Conclusion: In a Bayesian meta-analysis adjusted for publication bias, there was moderate or strong evidence for an association of RVEF with outcomes for only four CVDs. Additional data may strengthen evidence regarding other CVDs.

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