Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
Department of Radiology, The First Bethune Hospital of Jilin University, Changchun, Jilin, China.
Clin Cardiol. 2022 Dec;45(12):1184-1191. doi: 10.1002/clc.23928. Epub 2022 Sep 30.
As previously reported, impairment of left ventricular global longitudinal strain (LVGLS) is associated with myocardial fibrosis, arrhythmias, and heart failure in hypertrophic cardiomyopathy (HCM) patients.
This study aimed to estimate the association between LVGLS measured by echocardiography and major adverse cardiovascular events (MACE) in patients with HCM.
Pubmed, Embase, Scopus, and Cochrane Library databases were systematically searched for evaluating the difference of LVGLS between MACE and non-MACE and the relevance of LVGLS and MACE in HCM patients, mean difference (MD), and pooled hazard ratios (HR) with 95% confidence interval (CI) were calculated. Publication bias was detected by funnel plots and Egger's test, and trim-and-fill analysis was employed when publication bias existed.
A total of 13 studies reporting 2441 HCM patients were included in this meta-analysis. Absolute value of LVGLS was lower in the group of HCM with MACE (MD = 2.74, 95% CI: 2.50-2.99, p < .001; I = 0, p = .48). In the pooled unadjusted model, LVGLS was related to MACE (HR = 1.14, 95% CI: 1.06-1.22, p < .05, I = 58.4%, p < .01) and there is a mild heterogeneity, and sensitivity analysis showed stable results. In the pooled adjusted model, LVGLS was related to MACE (HR = 1.12, 95% CI: 1.08-1.16, p < .05; I = 0%, p = .442). Egger's tests showed publication bias, and trim-and-fill analysis was applied, with final results similar to the previous and still statistically significant.
The meta-analysis suggested that impaired LVGLS was associated with poor prognosis in HCM patients.
正如之前报道的，左心室整体纵向应变（LVGLS）的损伤与肥厚型心肌病（HCM）患者的心肌纤维化、心律失常和心力衰竭有关。
本研究旨在评估超声心动图测量的 LVGLS 与 HCM 患者主要不良心血管事件（MACE）之间的相关性。
系统检索了 Pubmed、Embase、Scopus 和 Cochrane Library 数据库，以评估 MACE 和非 MACE 患者之间 LVGLS 的差异，以及 LVGLS 与 HCM 患者 MACE 的相关性，计算均值差（MD）和合并危险比（HR）及 95%置信区间（CI）。通过漏斗图和 Egger 检验检测发表偏倚，当存在发表偏倚时采用修剪和填充分析。
本荟萃分析共纳入了 13 项研究，共 2441 例 HCM 患者。MACE 组 HCM 患者的 LVGLS 绝对值较低（MD=2.74，95%CI：2.50-2.99，p<0.001；I=0，p=0.48）。在合并的未调整模型中，LVGLS 与 MACE 相关（HR=1.14，95%CI：1.06-1.22，p<0.05，I=58.4%，p<0.01），存在轻度异质性，敏感性分析结果稳定。在合并的调整模型中，LVGLS 与 MACE 相关（HR=1.12，95%CI：1.08-1.16，p<0.05；I=0%，p=0.442）。Egger 检验显示存在发表偏倚，采用修剪和填充分析，最终结果与之前相似，且仍具有统计学意义。
荟萃分析表明，LVGLS 受损与 HCM 患者的不良预后相关。
