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Normal ranges of left atrial strain by speckle-tracking echocardiography: A systematic review and meta-analysis


Pathan, F and D'Elia, N and Nolan, MT and Marwick, TH and Negishi, K, Normal ranges of left atrial strain by speckle-tracking echocardiography: A systematic review and meta-analysis, Journal of the American Society of Echocardiography, 30, (1) pp. 59-70. ISSN 0894-7317 (2017) [Refereed Article]

Copyright Statement

Copyright 2016 by the American Society of Echocardiography

DOI: doi:10.1016/j.echo.2016.09.007


Background: Recent advances in the assessment of myocardial function have facilitated the direct measurement of atrial function using speckle-tracking echocardiography. Currently, normal reference ranges for atrial function using speckle-tracking echocardiography are based on a few initial studies, with variations among modestly sized (n = 100-350) studies.

Methods: The authors searched the PubMed, Embase, and Scopus databases for the key terms "left atrial/atrial/atrium" and "strain/function/deformation/stiffness" and "speckle tracking/Velocity Vector Imaging/edge tracking." Studies of global left atrial function using speckle-tracking were selected if they involved >30 normal or healthy participants without any cardiac risk factors. Normal ranges for reservoir strain, conduit strain, and contractile strain were computed using a random-effects model. Meta-regression and subgroup analysis was performed to explore between-study heterogeneity.

Results: Forty studies (2,542 healthy subjects) satisfied the inclusion criteria. Meta-analysis revealed a normal reference range for reservoir strain of 39% (95% CI, 38%-41%, from 40 articles), for conduit strain of 23% (95% CI, 21%-25%, from 14 articles), and for contractile strain of 17% (95% CI, 16%-19%, from 18 articles). Meta-regression identified heart rate (P = .02) and body surface area (P = .003) as contributors to this heterogeneity. Subgroup analyses revealed heterogeneity due to sample size (n > 100 vs N < 100, P = .02).

Conclusions: The normal reference ranges for the three components of left atrial function are demonstrated. The between-study heterogeneity is explained partly by heart rate, body surface area, and sample size.

Item Details

Item Type:Refereed Article
Keywords:strain, atrial, normal range, meta-analysis
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Pathan, F (Dr Faraz Pathan)
UTAS Author:D'Elia, N (Mr Nic D'Elia)
UTAS Author:Nolan, MT (Mr Mark Nolan)
UTAS Author:Marwick, TH (Professor Tom Marwick)
UTAS Author:Negishi, K (Dr Kazuaki Negishi)
ID Code:114685
Year Published:2017
Web of Science® Times Cited:233
Deposited By:Menzies Institute for Medical Research
Deposited On:2017-02-23
Last Modified:2022-08-25

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