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Normal ranges of left atrial strain by speckle-tracking echocardiography: A systematic review and meta-analysis

Pathan, FK ORCID: 0000-0002-0939-5470, D'Elia, N, Nolan, MT, Marwick, TH ORCID: 0000-0001-9065-0899 and Negishi, K ORCID: 0000-0002-9086-2565 2017 , 'Normal ranges of left atrial strain by speckle-tracking echocardiography: A systematic review and meta-analysis' , Journal of the American Society of Echocardiography, vol. 30, no. 1 , pp. 59-70 , doi:

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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 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.

Item Type: Article
Authors/Creators:Pathan, FK and D'Elia, N and Nolan, MT and Marwick, TH and Negishi, K
Keywords: strain, atrial, normal range, meta-analysis
Journal or Publication Title: Journal of the American Society of Echocardiography
Publisher: Mosby
ISSN: 0894-7317
DOI / ID Number:
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Copyright 2016 by the American Society of Echocardiography

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