Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis
Abstract Aims Heart failure (HF) is a global health burden which prognostic assessment is currently challenging. Speckle tracking left atrial strain is widely recognized as a predictor of HF outcome. Our aim was to systematically investigate the prognostic value of peak atrial longitudinal strain (P...
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Wiley
2025-08-01
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| Series: | ESC Heart Failure |
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| Online Access: | https://doi.org/10.1002/ehf2.15302 |
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| author | Maria Concetta Pastore Mariangela Vigna Andrea Saglietto Maria Alma Iuliano Giulia Elena Mandoli Andrea Stefanini Chiara Carrucola Laura Fusini Luna Cavigli Flavio D'ascenzi Marta Focardi Serafina Valente Matteo Cameli |
| author_facet | Maria Concetta Pastore Mariangela Vigna Andrea Saglietto Maria Alma Iuliano Giulia Elena Mandoli Andrea Stefanini Chiara Carrucola Laura Fusini Luna Cavigli Flavio D'ascenzi Marta Focardi Serafina Valente Matteo Cameli |
| author_sort | Maria Concetta Pastore |
| collection | DOAJ |
| description | Abstract Aims Heart failure (HF) is a global health burden which prognostic assessment is currently challenging. Speckle tracking left atrial strain is widely recognized as a predictor of HF outcome. Our aim was to systematically investigate the prognostic value of peak atrial longitudinal strain (PALS) in acute and chronic HF and according to left ventricular (LV) function, age and gender. Methods and results A systematic literature search of medical databases was performed using PRISMA principles. All relevant studies reporting the prognostic value of LA strain in HF with reduced, mildly reduced and preserved ejection fraction (EF) with ≥6 months follow‐up were included. All‐cause mortality and HF hospitalization were considered as primary endpoint. Random‐effect meta‐analysis was performed to evaluate the pooled hazard ratios (HR) of the primary outcome. Eight studies (n = 5767 patients, median [interquartile range] age = 66.3 [65; 68.6]) satisfied the inclusion criteria (five chronic HF, two acute HF and one both). Median global PALS was 17.6 [14.9; 26.8]%, median LVEF was 36 [30; 56]%, median left ventricular global longitudinal strain (GLS) was −9% [−7; −16.9]. Over a median follow‐up of 903 [321; 1062] days, 2688 patients reached the primary endpoint (944 all‐cause mortality and 1963 hospitalizations). Each unit decrease in global PALS was independently associated with 5% increase for the primary endpoint (meta‐analytic HR = 1.05; 95% CI [1.02–1.07]; P < 0.01). Subgroup analysis showed no differences in acute and chronic HF (P = 0.18). Meta‐regression analysis showed a higher prognostic value of global PALS for lower values of LVEF (beta = −0.0023). Conclusions Global PALS may be used as prognostic tool in acute and chronic HF and especially in patients with reduced EF, providing an additional independent value for risk stratification in clinical practice. |
| format | Article |
| id | doaj-art-c6480eba6bcd48ffa47e8cd541a00acf |
| institution | Matheson Library |
| issn | 2055-5822 |
| language | English |
| publishDate | 2025-08-01 |
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| series | ESC Heart Failure |
| spelling | doaj-art-c6480eba6bcd48ffa47e8cd541a00acf2025-07-24T10:14:12ZengWileyESC Heart Failure2055-58222025-08-011242921293110.1002/ehf2.15302Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysisMaria Concetta Pastore0Mariangela Vigna1Andrea Saglietto2Maria Alma Iuliano3Giulia Elena Mandoli4Andrea Stefanini5Chiara Carrucola6Laura Fusini7Luna Cavigli8Flavio D'ascenzi9Marta Focardi10Serafina Valente11Matteo Cameli12Department of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyCardiovascular and Thoracic Department, Division of Cardiology Hospital Citta Della Salute e della Scienza di Torino Turin ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyCentro Cardiologico Monzino IRCCS Milan ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyDepartment of Medical Biotechnologies, Division of Cardiology University of Siena Siena ItalyAbstract Aims Heart failure (HF) is a global health burden which prognostic assessment is currently challenging. Speckle tracking left atrial strain is widely recognized as a predictor of HF outcome. Our aim was to systematically investigate the prognostic value of peak atrial longitudinal strain (PALS) in acute and chronic HF and according to left ventricular (LV) function, age and gender. Methods and results A systematic literature search of medical databases was performed using PRISMA principles. All relevant studies reporting the prognostic value of LA strain in HF with reduced, mildly reduced and preserved ejection fraction (EF) with ≥6 months follow‐up were included. All‐cause mortality and HF hospitalization were considered as primary endpoint. Random‐effect meta‐analysis was performed to evaluate the pooled hazard ratios (HR) of the primary outcome. Eight studies (n = 5767 patients, median [interquartile range] age = 66.3 [65; 68.6]) satisfied the inclusion criteria (five chronic HF, two acute HF and one both). Median global PALS was 17.6 [14.9; 26.8]%, median LVEF was 36 [30; 56]%, median left ventricular global longitudinal strain (GLS) was −9% [−7; −16.9]. Over a median follow‐up of 903 [321; 1062] days, 2688 patients reached the primary endpoint (944 all‐cause mortality and 1963 hospitalizations). Each unit decrease in global PALS was independently associated with 5% increase for the primary endpoint (meta‐analytic HR = 1.05; 95% CI [1.02–1.07]; P < 0.01). Subgroup analysis showed no differences in acute and chronic HF (P = 0.18). Meta‐regression analysis showed a higher prognostic value of global PALS for lower values of LVEF (beta = −0.0023). Conclusions Global PALS may be used as prognostic tool in acute and chronic HF and especially in patients with reduced EF, providing an additional independent value for risk stratification in clinical practice.https://doi.org/10.1002/ehf2.15302AcuteChronicHeart failureLeft atrial strainPrognosisSpeckle tracking |
| spellingShingle | Maria Concetta Pastore Mariangela Vigna Andrea Saglietto Maria Alma Iuliano Giulia Elena Mandoli Andrea Stefanini Chiara Carrucola Laura Fusini Luna Cavigli Flavio D'ascenzi Marta Focardi Serafina Valente Matteo Cameli Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis ESC Heart Failure Acute Chronic Heart failure Left atrial strain Prognosis Speckle tracking |
| title | Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis |
| title_full | Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis |
| title_fullStr | Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis |
| title_full_unstemmed | Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis |
| title_short | Prognostic value of left atrial strain in acute and chronic heart failure: A meta‐analysis |
| title_sort | prognostic value of left atrial strain in acute and chronic heart failure a meta analysis |
| topic | Acute Chronic Heart failure Left atrial strain Prognosis Speckle tracking |
| url | https://doi.org/10.1002/ehf2.15302 |
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