Left atrial strain predicts outcome in cardiovascular diseases: a systematic review and meta-analysis

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Aims The prognostic role of left atrial volume is well established in a variety of cardiovascular conditions but left atrial enlargement may occur at a relatively advanced stage of disease. Left atrial function measured by atrial strain could represent an early marker of disease. The aim of this meta-analysis was to evaluate the predictive value of left atrial strain (LAS) for major cardiovascular events in patients with cardiovascular diseases. Methods and results We systematically searched PUBMED, COCHRANE Central Register of Controlled Trials and WEB OF SCIENCE (WoS) up to May 2021 to identify studies including the relationship between LAS measured by speckle-tracking echocardiography and cardiovascular outcome (mortality and hospitalization for heart failure). A meta-analysis following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework was conducted. Nine reports including 6021 patients were eligible. The meta-analysis revealed that LAS predicted outcome in a population with a variety of cardiovascular conditions, that is heart failure, valvular heart disease, ischemic heart disease and left ventricular hypertrophy (HR 0.95; 95% CI 0.91–0.98). The result was confirmed in patients with heart failure (HR, 0.74; 95% CI, 0.55–1) or valvular heart disease (HR, 0.94; 95% CI, 0.90-.97). Conclusions LAS represents a powerful predictor of major cardiovascular events in patients with different cardiovascular diseases. Patients having lower values of LAS are at increased risk of mortality and hospitalizations for HF.