Quantitative assessment of left ventricular function by 3-dimensional speckle-tracking echocardiography in patients with chronic heart failure: a meta-analysis.

OBJECTIVES: To provide a comprehensive analysis of the clinical utility of 3-dimensional (3D) speckle-tracking echocardiography for left ventricular (LV) function in patients with chronic heart failure (CHF).

METHODS: Literature searches were conducted in the PubMed, Embase, Web of Science, and China BioMedicine databases on relevant articles published before October 1, 2012. Crude standardized mean differences with 95% confidence intervals (CIs) were calculated.

RESULTS: Seven case-control studies were included with a total of 375 patients with CHF and 181 healthy control participants. Meta-analysis results showed that the LV ejection fraction in the patients was significantly lower than in the controls (standardized mean difference, -4.62; 95% CI, -6.19 to -3.04), whereas the LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) in the patients were higher than in the controls (LVEDV: standardized mean difference, 1.76; 95% CI, 1.09 to 2.44; LVESV: standardized mean difference, 2.04, 95% CI, 1.30 to 2.78). The results also indicated that the patients had a greater delay in the standard deviation of the time to peak area tracking and the maximum difference in the time to peak area tracking in the 16 LV segments than the controls (standard deviation of the time to peak area tracking: standardized mean difference, 3.01; 95% CI, 1.73 to 4.29; maximum difference in the time to peak area tracking: standardized mean difference, 3.26; 95% CI, 1.58 to 4.93). Furthermore, global longitudinal, circumferential, and radial strain were also significantly impaired in the patients compared to the controls (longitudinal strain: standardized mean difference, 2.75; 95% CI, 1.11 to 4.39; circumferential strain: standardized mean difference, 2.71; 95% CI, 1.15 to 4.27; radial strain: standardized mean difference, 1.80; 95% CI, 0.45 to 3.14).

CONCLUSIONS: This meta-analysis suggests that LV function in patients with CHF can be noninvasively and objectively measured by 3D speckle-tracking echocardiography.