METHODS: Systematic literature searches of PubMed, Embase, and EuropePMC databases were performed on 16 November 2020. Left ventricular global longitudinal strain (LV-GLS) refers to LV contraction measurement using the speckle tracking-based method refers to the mean of strain values of the RV free wall (three segments) measured using echocardiography. The main outcome was poor outcome, defined as a composite of mortality and severe COVID-19.
RESULTS: Seven studies comprising of 612 patients were included in meta-analysis. Six studies have mortality as their outcome, and 1 study has severity as their outcome. Patients with poor outcome have lower LV-GLS (SMD 1.15 (0.57, 1.72), p < 0.001; I2 70.4%). Each 1% decrease in LV-GLS was associated with 1.4x increased risk of poor outcome (OR 1.37 (1.12, 1.67), p = 0.002; I2 48.8%). Patients with poor outcome have lower RV-LS (SMD 1.18 (0.91, 1.45), p < 0.001; I2 0%). Each 1% decrease in RV-LS was associated with 1.3x increased risk of poor outcome (OR 1.25 (1.15, 1.35), p < 0.001; I2 11.8%). Subgroup analysis showed that for every 1% decrease in LV-GLS and RV-LS is increased mortality with OR of 1.30 (1.12, 1.50) and OR of 1.24 (1.14, 1.35), respectively.
CONCLUSIONS: This study shows that lower LV-GLS and RV-LS measurements were associated with poor outcome in patients with COVID-19.
BACKGROUND: PROSPERO CRD42020221144.
方法:PubMed的系统文献检索,Embase,和EuropePMC数据库于2020年11月16日进行。左心室整体纵向应变(LV-GLS)是指使用基于斑点追踪的方法测量的LV收缩是指使用超声心动图测量的RV游离壁(三个节段)的应变值的平均值。主要结果是结果不佳,定义为死亡率和严重COVID-19的复合。
结果:在荟萃分析中纳入了由612名患者组成的7项研究。六项研究的结果是死亡率,1项研究的结果是严重程度。预后不良的患者LV-GLS较低(SMD1.15(0.57,1.72),p<0.001;I270.4%)。LV-GLS每降低1%,不良结局风险增加1.4倍(OR1.37(1.12,1.67),p=0.002;I248.8%)。预后不良的患者RV-LS较低(SMD1.18(0.91,1.45),p<0.001;I20%)。RV-LS每减少1%,不良结局风险增加1.3倍(OR1.25(1.15,1.35),p<0.001;I211.8%)。亚组分析显示,LV-GLS和RV-LS每降低1%,死亡率增加,OR为1.30(1.12,1.50),OR为1.24(1.14,1.35),分别。
结论:这项研究表明,在COVID-19患者中,较低的LV-GLS和RV-LS测量值与不良预后相关。
背景:PROSPEROCRD42020221144.