Diagnostic value of transthoracic echocardiography in type A acute aortic dissection: a systematic review and meta-analysis

Objective To evaluate the diagnostic value of TTE (transthoracic echocardiography) in type A acute aortic dissection. Methods The databases of PubMed, EMbase, the Cochrane Library, CNKI and WanFang Data were searched to collect the diagnostic feature on transthoracic echocardiography for type A acute aortic dissection published before Dec 2015.Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality.Then, Meta-Disc software (Version 1.4) was used to carry out statistical analyses, draw the summary receiver operating characteristic (SROC) curve, and calculate the area under curve and Q* index. Results A total of 9 studies involving 1 631 patients were included.The values of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under of SROC curve, and Q* index were 79%, 95%, 11.99, 0.22, 74.25, 0.940 7, and 0.878 3, respectively. Conclusions This Meta-analysis shows that TTE as a single indicator has high accuracy for early diagnosing type A aortic dissection.It should be combined with other diagnostic indicators to further improve the sensitivity and accuracy in diagnosing type A aortic dissection. Key words: Transthoracic echocardiography; Type A aortic dissection; Diagnostic test; Sensitivity; Specificity; Accuracy; Heterogeneity; Meta-analysis