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Compromised left atrial function and increased size predict raised cavity pressure: a systematic review and meta-analysis
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Universi College, Pristina, Kosovo, Albania; Clinic of Cardiology, University Clinical Centre of Kosovo, Pristina, Kosovo, Albania.ORCID-id: 0000-0002-8996-4257
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Universi College, Pristina, Kosovo, Albania.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Klinisk fysiologi.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Molecular and Clinic Research Institute, St George University, and7Brunel University, London, UK.
2019 (engelsk)Inngår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 39, nr 5, s. 297-307Artikkel, forskningsoversikt (Fagfellevurdert) Published
Abstract [en]

Aim: This meta-analysis assesses left atrial (LA) cavity and myocardial function measurements that predict pulmonary capillary wedge pressure (PCWP). Methods: PubMed-MEDLINE, EMBASE, Scopus, Google Scholar and the Cochrane Central Registry were searched up to December 2018 for studies on the relationship of LA diameter, LA indexed volume (LAVI max, LAVI min), peak atrial longitudinal (PALS), peak atrial contraction (PACS) strain and total emptying fraction (LAEF) with PCWP. Eighteen studies with 1343 patients were included. sensitivity and specificity (with 95% CI) for evaluation of diagnostic accuracy and the best cut-off values for different LA indices in predicting raised PCWP were estimated using summary receiver operating characteristic analysis. Results: The pooled analysis showed association between PCWP and LA diameter: Cohen's d = 0 center dot 87, LAVI max: d = 0 center dot 92 and LAVI min: d = 1 center dot 0 (P<0 center dot 001 for all). A stronger correlation was found between PCWP and PALS: d = 1 center dot 26, and PACS: d = 1 center dot 62, total EF d = 1 center dot 22 (P<0 center dot 0001 for all). PALS <= 19% had a summary sensitivity of 80% (65-90) and summary specificity of 77% (52-92), positive likelihood ratio (LR+) 3 center dot 74, negative likelihood ratio (LR-) DOR > 15 center dot 1 whereas LAVI >= 34 ml m(-2) had summary sensitivity of 75% (55-89) and summary specificity 77% (57-90), with LR+ >3, LR- 0 center dot 32 and DOR >10 center dot 1. Conclusions: Compromised LA myocardial function and increased size predict raised cavity pressure. These results should assist in optimum follow-up of patients with fluctuating LA pressure.

sted, utgiver, år, opplag, sider
John Wiley & Sons, 2019. Vol. 39, nr 5, s. 297-307
Emneord [en]
left atrial, left atrial function, left atrial size, left atrial strain, pulmonary capillary wedge pressure
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-162835DOI: 10.1111/cpf.12587ISI: 000479117100001PubMedID: 31136072OAI: oai:DiVA.org:umu-162835DiVA, id: diva2:1351113
Tilgjengelig fra: 2019-09-13 Laget: 2019-09-13 Sist oppdatert: 2019-09-13bibliografisk kontrollert

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