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Normal ranges of left ventricular strain in children: a meta-analysis.

Jashari H, Rydberg A, Ibrahimi P, Bajraktari G, Kryeziu L, Jashari F, Henein MY - Cardiovasc Ultrasound (2015)

Bottom Line: Data were combined using a random-effect model.Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS.Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

ABSTRACT

Aims: The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures.

Methods and results: A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used.

Conclusion: Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient's follow up.

No MeSH data available.


Related in: MedlinePlus

Normal value of RS. The forest plot lists the names of the studies in subgroups. The means and CIs including the results for variance, used in the inverse variance correction are shown
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Fig7: Normal value of RS. The forest plot lists the names of the studies in subgroups. The means and CIs including the results for variance, used in the inverse variance correction are shown

Mentions: RS meta-analysis from 18 datasets of different age groups varied from 24.9 to 62.1 (mean, 45.4; 95 % CI, 43.0 to 47.8) (Fig. 7). Overall study heterogeneity was 1764 (p < 0.0001) and inconsistency was 99.03 %. Vendor was the only significant determinant of inter-study variability (p = 0.005). There was no evidence for publication bias (p = 0.122). Three studies of different age groups were not enough for meta-analysis of RSRs.Fig. 7


Normal ranges of left ventricular strain in children: a meta-analysis.

Jashari H, Rydberg A, Ibrahimi P, Bajraktari G, Kryeziu L, Jashari F, Henein MY - Cardiovasc Ultrasound (2015)

Normal value of RS. The forest plot lists the names of the studies in subgroups. The means and CIs including the results for variance, used in the inverse variance correction are shown
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4528396&req=5

Fig7: Normal value of RS. The forest plot lists the names of the studies in subgroups. The means and CIs including the results for variance, used in the inverse variance correction are shown
Mentions: RS meta-analysis from 18 datasets of different age groups varied from 24.9 to 62.1 (mean, 45.4; 95 % CI, 43.0 to 47.8) (Fig. 7). Overall study heterogeneity was 1764 (p < 0.0001) and inconsistency was 99.03 %. Vendor was the only significant determinant of inter-study variability (p = 0.005). There was no evidence for publication bias (p = 0.122). Three studies of different age groups were not enough for meta-analysis of RSRs.Fig. 7

Bottom Line: Data were combined using a random-effect model.Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS.Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age.

View Article: PubMed Central - PubMed

Affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

ABSTRACT

Aims: The definition of normal values of two-dimensional speckle-tracking echocardiography derived left ventricular (LV) deformation parameters, is of critical importance for the routine application of this modality in children. The objectives of this study were to perform a meta-analysis of normal ranges for longitudinal, circumferential and radial strain/strain rate values and to identify confounders that may contribute to differences in reported measures.

Methods and results: A systematic search was conducted. Studies describing normal healthy subjects and observational studies that used control groups as a comparison were included. Data were combined using a random-effect model. Effects of demographic, clinical and equipment variables were assessed through meta-regression. The search identified 1,192 subjects form 28 articles. Longitudinal strain (LS) normal mean values varied from -12.9 to -26.5 (mean, -20.5; 95% CI, -20.0 to -21.0). Normal mean values of circumferential strain (CS) varied from -10.5 to -27.0 (mean, -22.06; 95% CI, -21.5 to -22.5). Radial strain (RS) normal mean values varied from 24.9 to 62.1 (mean, 45.4; 95% CI, 43.0 to 47.8). Meta-regression showed LV end diastolic diameter as a significant determinant of variation for LS. Longitudinal systolic strain rate (LSRs) was significantly determined by the age and RS by the type of vendor used.

Conclusion: Variations among different normal ranges were dependent on the vendor used, LV end-diastolic diameter and age. Vendor-independent software for analyzing myocardial deformation in children, using images from different vendors would be the ideal solution for strain measurements or else using the same system for patient's follow up.

No MeSH data available.


Related in: MedlinePlus