Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis

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• 作者：Faraz Pathan ; MBBS^a ; Nicholas D'Elia ; BSc^a ; Mark T. Nolan ; MBBS^a ; Thomas H. Marwick ; MBBS ; PhD ; MPH^a ; ^b ; Kazuaki Negishi ; MD ; PhD^a ; ^{kazuaki.negishi@utas.edu.au}
• 关键词：Strain ; Atrial ; Normal range ; Meta-analysis
• 刊名：Journal of the American Society of Echocardiography
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：30
• 期：1
• 页码：59-70.e8
• 全文大小：865 K
• 卷排序：30

文摘

Recent advances in the assessment of myocardial function have facilitated the direct measurement of atrial function using speckle-tracking echocardiography. Currently, normal reference ranges for atrial function using speckle-tracking echocardiography are based on a few initial studies, with variations among modestly sized (n = 100–350) studies.MethodsThe authors searched the PubMed, Embase, and Scopus databases for the key terms “left atrial/atrial/atrium” and “strain/function/deformation/stiffness” and “speckle tracking/Velocity Vector Imaging/edge tracking.” Studies of global left atrial function using speckle-tracking were selected if they involved >30 normal or healthy participants without any cardiac risk factors. Normal ranges for reservoir strain, conduit strain, and contractile strain were computed using a random-effects model. Meta-regression and subgroup analysis was performed to explore between-study heterogeneity.ResultsForty studies (2,542 healthy subjects) satisfied the inclusion criteria. Meta-analysis revealed a normal reference range for reservoir strain of 39% (95% CI, 38%–41%, from 40 articles), for conduit strain of 23% (95% CI, 21%–25%, from 14 articles), and for contractile strain of 17% (95% CI, 16%–19%, from 18 articles). Meta-regression identified heart rate (P = .02) and body surface area (P = .003) as contributors to this heterogeneity. Subgroup analyses revealed heterogeneity due to sample size (n > 100 vs N < 100, P = .02).ConclusionsThe normal reference ranges for the three components of left atrial function are demonstrated. The between-study heterogeneity is explained partly by heart rate, body surface area, and sample size.