左、右心室纵向应变与COVID-19的不良预后相关：一项系统综述和荟萃分析。
Left and right ventricular longitudinal strains are associated with poor outcome in COVID-19: a systematic review and meta-analysis.
作者信息
Wibowo Arief, Pranata Raymond, Astuti Astri, Tiksnadi Badai Bhatara, Martanto Erwan, Martha Januar Wibawa, Purnomowati Augustine, Akbar Mohammad Rizki
机构信息
Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Padjadjaran, Rumah Sakit Umum Pusat Hasan Sadikin, Jalan Professor Eyckman No.38, Pasteur, Bandung, Jawa Barat, 40161, Indonesia.
Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.
出版信息
J Intensive Care. 2021 Jan 12;9(1):9. doi: 10.1186/s40560-020-00519-3.
BACKGROUND
This systematic review and meta-analysis aimed to assess whether ventricular longitudinal strain can be used as a prognostication tool in patients with coronavirus disease 2019 (COVID-19).
METHODS
Systematic literature searches of PubMed, Embase, and EuropePMC databases were performed on 16 November 2020. Left ventricular global longitudinal strain (LV-GLS) refers to LV contraction measurement using the speckle tracking-based method refers to the mean of strain values of the RV free wall (three segments) measured using echocardiography. The main outcome was poor outcome, defined as a composite of mortality and severe COVID-19.
RESULTS
Seven studies comprising of 612 patients were included in meta-analysis. Six studies have mortality as their outcome, and 1 study has severity as their outcome. Patients with poor outcome have lower LV-GLS (SMD 1.15 (0.57, 1.72), p < 0.001; I 70.4%). Each 1% decrease in LV-GLS was associated with 1.4x increased risk of poor outcome (OR 1.37 (1.12, 1.67), p = 0.002; I 48.8%). Patients with poor outcome have lower RV-LS (SMD 1.18 (0.91, 1.45), p < 0.001; I 0%). Each 1% decrease in RV-LS was associated with 1.3x increased risk of poor outcome (OR 1.25 (1.15, 1.35), p < 0.001; I 11.8%). Subgroup analysis showed that for every 1% decrease in LV-GLS and RV-LS is increased mortality with OR of 1.30 (1.12, 1.50) and OR of 1.24 (1.14, 1.35), respectively.
CONCLUSION
This study shows that lower LV-GLS and RV-LS measurements were associated with poor outcome in patients with COVID-19.
TRIAL REGISTRATION
PROSPERO CRD42020221144.
背景
本系统评价和荟萃分析旨在评估心室纵向应变是否可作为2019冠状病毒病（COVID-19）患者的预后评估工具。
方法
于2020年11月16日对PubMed、Embase和EuropePMC数据库进行系统文献检索。左心室整体纵向应变（LV-GLS）是指使用基于斑点追踪的方法测量左心室收缩，右心室自由壁（三个节段）的应变值均值是指使用超声心动图测量的值。主要结局为不良结局，定义为死亡和重症COVID-19的综合情况。
结果
7项研究共612例患者纳入荟萃分析。6项研究以死亡作为结局，1项研究以严重程度作为结局。不良结局患者的LV-GLS较低（标准化均数差1.15（0.57，1.72），p<0.001；I² 70.4%）。LV-GLS每降低1%，不良结局风险增加1.4倍（比值比1.37（1.12，1.67），p = 0.002；I² 48.8%）。不良结局患者的右心室纵向应变（RV-LS）较低（标准化均数差1.18（0.91，1.45），p<0.001；I² 0%）。RV-LS每降低1%，不良结局风险增加1.3倍（比值比1.25（1.15, 1.35），p<0.001；I² 11.8%）。亚组分析显示，LV-GLS和RV-LS每降低1%，死亡率分别增加，比值比分别为1.30（1.12，1.50）和1.24（1.14，1.35）。
结论
本研究表明，较低的LV-GLS和RV-LS测量值与COVID-19患者的不良结局相关。
试验注册
PROSPERO CRD42020221144。
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