Chung-Yen Lee MS , Yosuke Nabeshima MD, PhD , Tetsuji Kitano MD, PhD , Catalina A. Parasca MD , Andreea Calin MD , Bogdan A. Popescu MD , Masaaki Takeuchi MD, PhD
{"title":"主动脉瓣狭窄患者右心室自由壁纵向应变的预后价值:一项系统回顾和meta分析。","authors":"Chung-Yen Lee MS , Yosuke Nabeshima MD, PhD , Tetsuji Kitano MD, PhD , Catalina A. Parasca MD , Andreea Calin MD , Bogdan A. Popescu MD , Masaaki Takeuchi MD, PhD","doi":"10.1016/j.jjcc.2023.11.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Assessment of right ventricular (RV) function in aortic stenosis<span> (AS) may improve risk stratification<span>. However, whether the prognostic value of RV free-wall longitudinal strain (RVfwLS) is better than that of other right heart or pulmonary circulation<span> parameters remains uncertain. This study assessed and compared the prognostic value of RVfwLS with traditional parameters in the AS population using a systematic review and meta-analysis.</span></span></span></p></div><div><h3>Methods</h3><p>We selected studies reporting the hazard ratio (HR) of RVfwLS in patients<span> with AS. We also collected data regarding the HR of systolic pulmonary arterial pressure (SPAP), fractional area change (FAC), and tricuspid annulus plane systolic excursion (TAPSE). To ensure comparability, we standardized the HR using within-study standard deviations. The comparison between the prognostic value of RVfwLS and other parameters was conducted as a ratio of HR.</span></p></div><div><h3>Results</h3><p>This meta-analysis included 9 studies comprising a total of 2547 patients, with 679 events. The pooled HR of RVfwLS was 1.56 (95 % CI: 1.39–1.75, <em>p</em> < 0.001). When examining the ratio of HR between RVfwLS and conventional parameters, all comparisons were statistically non-significant [RVfwLS/SPAP: 1.28 (95 % CI: 0.99–1.65, <em>p</em> = 0.06); RVfwLS/FAC: 1.24 (95 % CI: 0.90–1.72, <em>p</em> = 0.14); and RVfwLS/TAPSE:1.07 (95 % CI: 0.75–1.52, <em>p</em> = 0.60)].</p></div><div><h3>Conclusions</h3><p>This meta-analysis establishes a substantial association between RVfwLS and adverse outcomes in the AS population. However, comparative analysis between RVfwLS and SPAP, FAC, or TAPSE did not support the prognostic superiority of RVfwLS.</p></div>","PeriodicalId":15223,"journal":{"name":"Journal of cardiology","volume":null,"pages":null},"PeriodicalIF":2.5000,"publicationDate":"2023-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic value of right ventricular free-wall longitudinal strain in aortic stenosis: A systematic review and meta-analysis\",\"authors\":\"Chung-Yen Lee MS , Yosuke Nabeshima MD, PhD , Tetsuji Kitano MD, PhD , Catalina A. Parasca MD , Andreea Calin MD , Bogdan A. Popescu MD , Masaaki Takeuchi MD, PhD\",\"doi\":\"10.1016/j.jjcc.2023.11.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Assessment of right ventricular (RV) function in aortic stenosis<span> (AS) may improve risk stratification<span>. However, whether the prognostic value of RV free-wall longitudinal strain (RVfwLS) is better than that of other right heart or pulmonary circulation<span> parameters remains uncertain. This study assessed and compared the prognostic value of RVfwLS with traditional parameters in the AS population using a systematic review and meta-analysis.</span></span></span></p></div><div><h3>Methods</h3><p>We selected studies reporting the hazard ratio (HR) of RVfwLS in patients<span> with AS. We also collected data regarding the HR of systolic pulmonary arterial pressure (SPAP), fractional area change (FAC), and tricuspid annulus plane systolic excursion (TAPSE). To ensure comparability, we standardized the HR using within-study standard deviations. The comparison between the prognostic value of RVfwLS and other parameters was conducted as a ratio of HR.</span></p></div><div><h3>Results</h3><p>This meta-analysis included 9 studies comprising a total of 2547 patients, with 679 events. The pooled HR of RVfwLS was 1.56 (95 % CI: 1.39–1.75, <em>p</em> < 0.001). When examining the ratio of HR between RVfwLS and conventional parameters, all comparisons were statistically non-significant [RVfwLS/SPAP: 1.28 (95 % CI: 0.99–1.65, <em>p</em> = 0.06); RVfwLS/FAC: 1.24 (95 % CI: 0.90–1.72, <em>p</em> = 0.14); and RVfwLS/TAPSE:1.07 (95 % CI: 0.75–1.52, <em>p</em> = 0.60)].</p></div><div><h3>Conclusions</h3><p>This meta-analysis establishes a substantial association between RVfwLS and adverse outcomes in the AS population. However, comparative analysis between RVfwLS and SPAP, FAC, or TAPSE did not support the prognostic superiority of RVfwLS.</p></div>\",\"PeriodicalId\":15223,\"journal\":{\"name\":\"Journal of cardiology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2023-12-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0914508723002873\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of cardiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0914508723002873","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景:评估主动脉瓣狭窄(AS)患者的右心室(RV)功能可以改善危险分层。然而,右心室自由壁纵向应变(RVfwLS)是否优于其他右心循环或肺循环参数的预后价值仍不确定。本研究通过系统回顾和荟萃分析,评估并比较了RVfwLS与AS人群中传统参数的预后价值。方法:我们选择了报道AS患者RVfwLS风险比(HR)的研究。我们还收集了收缩期肺动脉压HR (SPAP)、分数面积变化(FAC)和三尖瓣环平面收缩偏移(TAPSE)的数据。为了确保可比性,我们使用研究内标准差对人力资源进行了标准化。RVfwLS与其他参数的预后价值以HR比值进行比较。结果:本荟萃分析包括9项研究,共2547例患者,679例事件。RVfwLS的总风险比为1.56(95 % CI: 1.39-1.75, p )。结论:该荟萃分析在AS人群中建立了RVfwLS与不良结局之间的实质性关联。然而,RVfwLS与SPAP、FAC或TAPSE的比较分析并不支持RVfwLS的预后优势。
Prognostic value of right ventricular free-wall longitudinal strain in aortic stenosis: A systematic review and meta-analysis
Background
Assessment of right ventricular (RV) function in aortic stenosis (AS) may improve risk stratification. However, whether the prognostic value of RV free-wall longitudinal strain (RVfwLS) is better than that of other right heart or pulmonary circulation parameters remains uncertain. This study assessed and compared the prognostic value of RVfwLS with traditional parameters in the AS population using a systematic review and meta-analysis.
Methods
We selected studies reporting the hazard ratio (HR) of RVfwLS in patients with AS. We also collected data regarding the HR of systolic pulmonary arterial pressure (SPAP), fractional area change (FAC), and tricuspid annulus plane systolic excursion (TAPSE). To ensure comparability, we standardized the HR using within-study standard deviations. The comparison between the prognostic value of RVfwLS and other parameters was conducted as a ratio of HR.
Results
This meta-analysis included 9 studies comprising a total of 2547 patients, with 679 events. The pooled HR of RVfwLS was 1.56 (95 % CI: 1.39–1.75, p < 0.001). When examining the ratio of HR between RVfwLS and conventional parameters, all comparisons were statistically non-significant [RVfwLS/SPAP: 1.28 (95 % CI: 0.99–1.65, p = 0.06); RVfwLS/FAC: 1.24 (95 % CI: 0.90–1.72, p = 0.14); and RVfwLS/TAPSE:1.07 (95 % CI: 0.75–1.52, p = 0.60)].
Conclusions
This meta-analysis establishes a substantial association between RVfwLS and adverse outcomes in the AS population. However, comparative analysis between RVfwLS and SPAP, FAC, or TAPSE did not support the prognostic superiority of RVfwLS.
期刊介绍:
The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.