Key result
Peak atrial longitudinal strain assessed by speckle-tracking echocardiography independently predicted postoperative atrial fibrillation after CABG (OR 0.88 per 1% increase; 95% CI 0.82-0.94; p<0.0001).
Why the study?
To investigate the prognostic role of left atrial strain assessment using speckle-tracking echocardiography to predict postoperative atrial fibrillation in patients undergoing coronary bypass grafting.
Does left atrial strain assessment using speckle-tracking echocardiography predict postoperative atrial fibrillation in patients undergoing CABG?
Meta-Analysis (n=1,093)
Does left atrial strain assessment using speckle-tracking echocardiography predict postoperative atrial fibrillation in patients undergoing CABG?
Odds Ratio: 0.88 (95% CI 0.82–0.94)
p-value: p=<0.0001
Left atrial strain assessment, particularly peak atrial longitudinal strain, using speckle-tracking echocardiography is a significant independent predictor of postoperative atrial fibrillation in patients undergoing isolated CABG.
May aid preoperative POAF risk stratification before CABG; confirms independent predictive value of peak atrial longitudinal strain.
Aim. To conduct a systematic review and meta-analysis to investigate the prognostic role of left atrial (LA) strain assessment using speckle-tracking echocardiography to predict postoperative atrial fibrillation (POAF) in patients undergoing coronary bypass grafting (CABG). Material and methods. We searched the PubMed (Medline) and Google Scholar databases for studies investigating LA strain measures obtained by speckle tracking echocardiography as predictors of POAF in patients after CABG. To determine the difference in the weighted average LA strain parameters, an analysis was made of the global LA strain, peak atrial longitudinal strain (PALS), left atrial conduit strain (LACS) and left atrial contractile strain (LACtS). Odds ratio (OR) values were received from multivariate models reporting association between PALS and POAF and described as pooled estimates with 95% confidence intervals (CI). Results. Twelve studies from 404 publications were selected for this systematic review and meta-analysis. A total of 1093 patients were included in the analysis, with a mean age of 60,5 years. A meta-analysis showed that patients with POAF had lower global LA strain than patients without POAF (difference in weighted values, 5,03%; 95% CI: -6,89 to -3,16; p<0,001). In addition, patients with POAF had lower PALS, LACS and LACtS; the difference in weighted values was 9,90% (95% CI: -12,95 to -6,85; p<0,001), 4,17% (95% CI: -6,05 to -2,29; p<0,001) and 6,1 7% (95% CI: -12,01 to -0,33; p=0,04), respectively. Moreover, in a pooled odds ratio (OR) analysis, PALS was found to be an independent predictor of POAF (OR: 0,88 for every 1% increase in PALS; 95% CI: 0,82–0,94; p<0,0001). Conclusion. Assessment of LA strain using speckle-tracking echocardiography provides important additional information for predicting POAF in patients undergoing isolated CABG.
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Голухова et al. (2023) conducted a meta-analysis in postoperative atrial fibrillation after coronary artery bypass grafting (n=1,093). Left atrial strain assessment (peak atrial longitudinal strain) was evaluated on postoperative atrial fibrillation (POAF) (OR 0.88, 95% CI 0.82-0.94, p=<0.0001). Peak atrial longitudinal strain assessed by speckle-tracking echocardiography independently predicted postoperative atrial fibrillation after CABG (OR 0.88 per 1% increase; 95% CI 0.82-0.94; p<0.0001).
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