Department of Medical Education Unit, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
Fifth Year Medical Student, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia.
PLoS One. 2022 Jun 7;17(6):e0269691. doi: 10.1371/journal.pone.0269691. eCollection 2022.
Global longitudinal strain (GLS) can identify subclinical myocardial dysfunction in patients with cirrhosis. This systematic review aims to provide evidence of a possible difference in GLS values between patients with cirrhosis and patients without cirrhosis. Studies from inception to August 11, 2021, were screened and included based on the inclusion criteria. The Newcastle Ottawa Scale was used to assess the quality of nonrandomized studies. Meta-analyses were conducted with subsequent sensitivity and subgroup analyses according to age, sex, cirrhosis etiology, and severity. Publication bias was evaluated using Begg's funnel plot, Egger's test, and rank correlation test with subsequent trim-and-fill analysis. The systematic database search yielded 20 eligible studies. Random effect showed a significant reduction of left ventricular (LV) GLS (MD:-1.43;95%; 95%CI,-2.79 to -0.07; p = 0.04; I2 = 95% p<0.00001) and right ventricular (RV) GLS (MD:-1.95; 95%CI,-3.86 to -0.05, p = 0.04; I2 = 90%, p<0.00001) in the group with cirrhosis. A sensitivity test on subgroup analysis based on the study design showed a -1.78% lower LV-GLS in the group with cirrhosis (I2 = 70%, p = 0.0003). Meta-regression analysis showed that the severity of cirrhosis was significantly related to GLS reduction. This research received no specific grants from any funding agency in the public, commercial, or not-for-profit sectors. The study protocol was registered at PROSPERO (CRD42020201630). We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement guidelines.
全球纵向应变（GLS）可识别肝硬化患者的亚临床心肌功能障碍。本系统评价旨在提供肝硬化患者与无肝硬化患者之间 GLS 值可能存在差异的证据。从研究开始到 2021 年 8 月 11 日筛选并纳入符合纳入标准的研究。使用纽卡斯尔-渥太华量表评估非随机研究的质量。根据年龄、性别、肝硬化病因和严重程度进行荟萃分析，随后进行敏感性分析和亚组分析。使用 Begg 漏斗图、Egger 检验和秩相关检验评估发表偏倚，随后进行修剪和填充分析。系统数据库搜索产生了 20 项合格的研究。随机效应显示，左心室（LV）GLS（MD：-1.43；95%CI：-2.79 至-0.07；p=0.04；I2=95%，p<0.00001）和右心室（RV）GLS（MD：-1.95；95%CI：-3.86 至-0.05，p=0.04；I2=90%，p<0.00001）在肝硬化组中显著降低。基于研究设计的亚组分析敏感性测试显示，肝硬化组的 LV-GLS 降低了-1.78%（I2=70%，p=0.0003）。Meta 回归分析表明，肝硬化的严重程度与 GLS 降低显著相关。本研究未从任何公共、商业或非营利部门的资助机构获得特定的资助。研究方案已在 PROSPERO（CRD42020201630）上注册。我们遵循了系统评价和荟萃分析的首选报告项目（PRISMA）2020 声明指南。
