The predictive value of right ventricle speckle tracking echocardiography in patients undergoing cardiac surgery, a systematic review and meta-analysis

BACKGROUND: Right ventricular (RV) dysfunction is a critical predictor of adverse outcomes in cardiac surgery patients. The assessment of right ventricular global longitudinal strain (GLS) echo has emerged as a promising tool for detecting early RV dysfunction. This meta-analysis evaluates the predictive value of RV GLS in these patients. METHODS: A comprehensive literature search was conducted. The primary outcomes included pooled diagnostic performance measures, including sensitivity, specificity, and the diagnostic odds ratio (DOR). A multiple-cutoff model was employed to determine the optimal RV-GLS threshold. RESULTS: Ten observational studies involving 583 patients were included. RV-GLS demonstrated strong diagnostic accuracy, with a pooled area under the summary receiver operating characteristic curve (AUC) of 0.90 (95% CI: 0.82-1.00). The pooled DOR was 6.34 (95% CI: 3.20-12.57) with no heterogeneity (I² = 0%). Sensitivity was 0.79 (95% CI: 0.69-0.86; I² = 57.2%) and specificity was 0.78 (95% CI: 0.71-0.84; I² = 20.8%). The risk of publication bias was low (LFK index = 0.6). A multiple-threshold model identified - 15.25% as the optimal RV-GLS cutoff, achieving balanced sensitivity and specificity of 0.7423. CONCLUSIONS: RV-GLS demonstrates excellent predictive value for RV dysfunction in cardiac surgery patients.