Normal ranges of left atrial strain by speckle-tracking echocardiography: a systematic review and meta-analysis
Nolan, MT; Negishi, K; Marwick, TH; Pathan, F; D'Elia, N
Abstract
BACKGROUND:
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.
METHODS:
The 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.
RESULTS:
Forty 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).
CONCLUSIONS:
The 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.
Copyright © 2016 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.
| Journal | J AM SOC ECHOCARDIOGR |
| ISSN | 0894-7317 |
| Published | 01 Jan 2017 |
| Volume | 30 |
| Issue | 1 |
| Pages | 59-70.e8 |
| DOI | 10.1016/j.echo.2016.09.007 |
| Type | Systematic Review |
| Sponsorship |