May 28, 2019Clinical Physiology and Functional Imaging
Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta‐analysis
Key result
Left atrial indices identify elevated PCWP with ~75% sensitivity and ~77% specificity.
- Sensitivity 75%, Specificity 77%
- 95% CI 55-89
- n=1,343
Why the study?
The predictive value of left atrial cavity and myocardial function measurements for pulmonary capillary wedge pressure was not well established.
Do left atrial cavity and myocardial function measurements accurately predict raised pulmonary capillary wedge pressure?
Comparison
Left atrial cavity and myocardial function measurements vs pulmonary capillary wedge pressure
Design
Systematic review and meta-analysis
Authors
Discussion
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Implication
LA strain and size predict elevated PCWP; extends correlations with quantified accuracy for noninvasive estimation in research.
Study Design
Type
Meta-Analysis (n=1,343)
Structured PICO
Do left atrial cavity and myocardial function measurements accurately predict raised pulmonary capillary wedge pressure?
P
Population
1,343 patients across 18 studies evaluating left atrial cavity and myocardial function measurements to predict raised pulmonary capillary wedge pressure.
E
Exposure
Left atrial (LA) cavity and myocardial function measurements (LA diameter, LA indexed volume [LAVI max, LAVI min], peak atrial longitudinal strain [PALS], peak atrial contraction strain [PACS], and total emptying fraction [LAEF])
O
Outcome
Diagnostic accuracy (summary sensitivity and specificity) for predicting raised pulmonary capillary wedge pressure (PCWP)surrogate
Main Result
Effect estimate: Sensitivity 75%, Specificity 77% (95% CI 55-89)
Left atrial size and myocardial function indices demonstrate moderate diagnostic accuracy for predicting elevated pulmonary capillary wedge pressure, offering a non-invasive method to assist in hemodynamic monitoring.
Cite This Study
Bytyçi et al. (2019) conducted a meta-analysis in Raised pulmonary capillary wedge pressure (n=1,343). Left atrial indices (LA diameter, LAVI, PALS, PACS, LAEF) was evaluated on Prediction of raised pulmonary capillary wedge pressure (Sensitivity 75%, Specificity 77%, 95% CI 55-89). Left atrial indices predicted raised pulmonary capillary wedge pressure with a summary sensitivity of 75% (95% CI 55-89) and summary specificity of 77% (95% CI 57-90).