Cardiology Department, Tehran Heart Center, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Sci Rep. 2024 Oct 29;14(1):25888. doi: 10.1038/s41598-024-76411-z.
Establishing normal values of left atrial (LA) phasic strains and strain rates is essential for distinguishing between normal and abnormal functions, determining the degree of abnormality, and understanding the clinical significance of reported values in pediatrics. This meta-analysis aimed to establish normal values of two-dimensional speckle-tracking echocardiography (2DSTE)-derived LA phasic strains and strain rates in the pediatric population and identify the sources of inter-study heterogeneity for these values. A comprehensive search of PubMed, Scopus, and Embase databases was conducted using keywords such as "left atrial/left atrium," "strain/speckle/deformation," and "echocardiography" combined with pediatric age categories. Inclusion criteria comprised English-language human studies involving healthy subjects under 18 years of age. Subjects were categorized as neonates (up to 1 month), infants (1-12 months), and children (1-18 years). A random-effects model was applied to determine 2DSTE-derived LA strains and strain rates, and a meta-regression analysis was performed to investigate inter-study heterogeneity. Our analysis included 17 studies involving 1448 healthy subjects. For children, the mean values of LA strains during the reservoir, conduit, and contraction phases were 47.3% (95% CI 42.5-52.1%), 32.8% (95% CI 27.8-37.8%), and 12% (95% CI 10.0-14.1%), respectively. The mean values for LA strain rates were 2.4 s (95% CI 1.1-3.8 s), 4.3 s (95% CI 0.6-8.0 s), and 2.4 s (95% CI 0.4-4.5 s), respectively. Inter-study heterogeneity for 2DSTE-derived LA phasic strains and strain rates was attributed to factors such as the number of study participants, publication year, software utilized, gating methods, the number of analyzed segments, the geographical region of the study, and heart rate. This study established the normal range of 2DSTE-derived LA phasic strains and strain rates. Additionally, inter-study heterogeneity was found to be influenced by various demographic, physiologic, and methodological factors.
建立左心房（LA）相应变值和应变速率的正常值对于区分正常和异常功能、确定异常程度以及理解报告值在儿科中的临床意义至关重要。本荟萃分析旨在建立儿科人群中二维斑点追踪超声心动图（2DSTE）衍生的 LA 相应变值和应变速率的正常值，并确定这些值的研究间异质性的来源。使用“左心房/左心房”、“应变/斑点/变形”和“超声心动图”等关键词，对 PubMed、Scopus 和 Embase 数据库进行了全面检索，并结合儿科年龄类别进行了组合。纳入标准包括使用英语撰写的、涉及 18 岁以下健康受试者的人类研究。受试者分为新生儿（1 个月内）、婴儿（1-12 个月）和儿童（1-18 岁）。应用随机效应模型确定 2DSTE 衍生的 LA 应变值和应变速率，并进行荟萃回归分析以研究研究间异质性。我们的分析包括 17 项涉及 1448 名健康受试者的研究。对于儿童，LA 在储存、传导和收缩阶段的应变平均值分别为 47.3%（95%CI 42.5-52.1%）、32.8%（95%CI 27.8-37.8%）和 12%（95%CI 10.0-14.1%）。LA 应变速率的平均值分别为 2.4 s（95%CI 1.1-3.8 s）、4.3 s（95%CI 0.6-8.0 s）和 2.4 s（95%CI 0.4-4.5 s）。2DSTE 衍生的 LA 相应变值和应变速率的研究间异质性归因于研究参与者数量、发表年份、使用的软件、门控方法、分析节段数量、研究地点、心率等因素。本研究建立了 2DSTE 衍生的 LA 相应变值和应变速率的正常范围。此外，研究间异质性还发现受各种人口统计学、生理学和方法学因素的影响。
