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Utility of speckle-tracking echocardiography for predicting atrial fibrillation following ischemic stroke: a systematic review and meta-analysis

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Abstract

Undiagnosed atrial fibrillation (AF) is one of the main sources of cryptogenic stroke. And strain indices measured by speckle-tracking echocardiography are associated with atrial remodeling supposed to be the substrate of AF. Therefore, there is a strong need for evaluating the utility of speckle-tracking echocardiography to predict the likelihood of AF in patients with cryptogenic stroke. PubMed, Embase and Cochrane Database were searched for studies. The random-effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) analysis was performed to show the overall predictive value. There were 1483 patients with cryptogenic stroke from 8 studies. Meta-analysis showed that strain indices including global longitudinal strain (GLS) (mean difference [SMD]: − 0.22, 95% confidence interval [95% CI] − 0.40 to − 0.04), left atrial reservoir strain (εR), (SMD: − 0.87, 95% CI − 1.26 to − 0.48, conduit strain (εCD) (SMD: − 0.56, 95% CI − 0.81 to − 0.30), contractile strain (εCT) (SMD: − 1.00, 95% CI − 1.39 to − 0.61), and left atrial reservoir strain rate (SRe) (SMD: − 0.54, 95% CI − 0.80 to − 0.28) measured at the period of cryptogenic stroke was significantly decreased in patients with AF occurrence compared to without. SROC analysis suggested an acceptable predictive efficiency of εR for AF occurrence (AUC = 0.799). For patients after cryptogenic stroke, GLS, εR, εCD, εCT and SRe were significantly decreased in AF occurrence compared with non-occurrence. But there was no value in left atrial reservoir strain rate (SRs) and contractile strain rate (SRa) for predicting AF.

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Funding

This work was supported by Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190902) of Professor Ping Zhang.

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  1. Qinggele Gao and Peng Liu contributed equally to this work as co-first authors.

Authors and Affiliations

  1. School of Clinical Medicine, Tsinghua University, Beijing, 100084, China

    Qinggele Gao, Peng Liu, Ying Yang & Ping Zhang

  2. Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, China

    Tingting Lv & Ping Zhang

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  1. Qinggele Gao
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  2. Peng Liu
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Correspondence to Ping Zhang.

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Gao, Q., Liu, P., Lv, T. et al. Utility of speckle-tracking echocardiography for predicting atrial fibrillation following ischemic stroke: a systematic review and meta-analysis. Int J Cardiovasc Imaging 38, 1771–1780 (2022). https://doi.org/10.1007/s10554-022-02570-7

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