Jia Fuwei, Chen Antian, Zhang Dingding, Fang Ligang, Chen Wei
Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Cardiovasc Med. 2022 Jul 1;9:935103. doi: 10.3389/fcvm.2022.935103. eCollection 2022.
Heart failure (HF) is a global health problem with high morbidity and mortality. Recently, the association between peak atrial longitudinal strain (PALS) and clinical outcomes of HF has gained increasing attention. Our aim was to systematically assess the prognostic value of PALS for adverse events in HF.
PubMed, Embase, and Scopus databases were systematically searched from inception to 30 April 2022. Studies in which PALS was assessed to predict adverse outcomes in adult patients with HF were included. Study selection, quality assessment, and data extraction were performed independently by two authors. The primary endpoints were all-cause death and cardiac hospitalization.
Among 7,787 patients in 17 included studies, 3,029 (38.9%) experienced the primary endpoint. Patients with events had lower PALS than those without events [weighted mean difference (WMD) 6.17, 95% confidence interval (CI) 3.09-9.26, < 0.001]. Each unit increment of PALS was independently associated with decreased risk for the primary endpoint [hazard ratio (HR) 0.96, 95% CI 0.94-0.98, < 0.001]. The addition of PALS significantly improved the predictive power of conventional risk models [net reclassification index (NRI) 0.22, 95% CI 0.06-0.39, = 0.008].
Peak atrial longitudinal strain was an independent predictor for all-cause mortality and cardiac hospitalization in patients with HF, highlighting the clinical importance of left atrial (LA) deformation in the prognosis of HF.
[www.crd.york.ac.uk/prospero/], identifier [CRD42020185034].
心力衰竭（HF）是一个具有高发病率和死亡率的全球性健康问题。最近，心房纵向应变峰值（PALS）与HF临床结局之间的关联受到越来越多的关注。我们的目的是系统评估PALS对HF不良事件的预后价值。
系统检索了PubMed、Embase和Scopus数据库，检索时间从数据库建立至2022年4月30日。纳入评估PALS预测成年HF患者不良结局的研究。由两位作者独立进行研究选择、质量评估和数据提取。主要终点为全因死亡和心脏住院。
在17项纳入研究的7787例患者中，3029例（38.9%）发生主要终点事件。发生事件的患者PALS低于未发生事件的患者[加权平均差（WMD）6.17，95%置信区间（CI）3.09 - 9.26，P < 0.001]。PALS每增加一个单位与主要终点事件风险降低独立相关[风险比（HR）0.96，95% CI 0.94 - 0.98，P < 0.001]。加入PALS显著提高了传统风险模型的预测能力[净重新分类指数（NRI）0.22，95% CI 0.06 - 0.39，P = 0.008]。
心房纵向应变峰值是HF患者全因死亡率和心脏住院的独立预测因子，突出了左心房（LA）变形在HF预后中的临床重要性。
