scholarly journals Left Ventricular Contraction Duration Is the Most Powerful Predictor of Cardiac Events in LQTS: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 9 (9) ◽  
pp. 2820 ◽  
Author(s):  
Mena Abdelsayed ◽  
Ibadete Bytyçi ◽  
Annika Rydberg ◽  
Michael Y. Henein
Keyword(s):  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Qtc Dispersion ◽  
Rr Interval ◽  
Contraction Duration ◽  
Asymptomatic Patients ◽  
Lower Accuracy

Background: Long-QT syndrome (LQTS) is primarily an electrical disorder characterized by a prolonged myocardial action potential. The delay in cardiac repolarization leads to electromechanical (EM) abnormalities, which adds a diagnostic value for LQTS. Prolonged left ventricular (LV) contraction was identified as a potential risk for arrhythmia. The aim of this meta-analysis was to assess the best predictor of all EM parameters for cardiac events (CEs) in LQTS patients. Methods: We systematically searched all electronic databases up to March 2020, to select studies that assessed the relationship between echocardiographic indices—contraction duration (CD), mechanical dispersion (MD), QRS onset to peak systolic strain (QAoC), and the EM window (EMW); and electrical indices— corrected QT interval (QTC), QTC dispersion, RR interval in relation to CEs in LQTS. This meta-analysis included a total of 1041 patients and 373 controls recruited from 12 studies. Results: The meta-analysis showed that LQTS patients had electrical and mechanical abnormalities as compared to controls—QTC, WMD 72.8; QTC dispersion, WMD 31.7; RR interval, WMD 91.5; CD, WMD 49.2; MD, WMD 15.9; QAoC, WMD 27.8; and EMW, WMD −62.4. These mechanical abnormalities were more profound in symptomatic compared to asymptomatic patients in whom disturbances were already manifest, compared to controls. A CD ≥430 ms had a summary sensitivity (SS) of 71%, specificity of 84%, and diagnostic odds ratio (DOR) >19.5 in predicting CEs. EMW and QTC had a lower accuracy. Conclusions: LQTS is associated with pronounced EM abnormalities, particularly prolonged LV myocardial CD, which is profound in symptomatic patients. These findings highlight the significant role of EM indices like CD in managing LQTS patients.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

scholarly journals Diagnostic and prognostic value of miRNAs in hepatoblastoma: A systematic review with meta-analysis

2021 ◽  
Author(s):  
Bin Wu ◽  
◽  
Lixia Guo ◽  
Kaikai Zhen ◽  
Chao Sun
Keyword(s):  
Systematic Review ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Prognostic Indicator ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Clinical Value ◽  
Diagnostic And Prognostic Value

Review question / Objective: Background and aim: Increasing evidence has revealed the valuable diagnostic and prognostic applications of dysregulated microRNAs (miRNAs) in hepatoblastoma (HB), the most common hepatic malignancy during childhood. However, these results are inconsistent and remain to be elucidated. In the present study, we aimed to systematically compile up-to-date information regarding the clinical value of miRNAs in HB. Methods: Articles concerning the diagnostic and prognostic value of single miRNAs for HB were searched from databases. The sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and hazard ratios (HRs) were separately pooled to explore the diagnostic and prognostic performance of miRNA. Subgroup and meta-regression analyses were further carried out only in the event of heterogeneity. Results: In all, 20 studies, involving 264 HB patients and 206 healthy individuals, met the inclusion criteria in the six included literature articles. For the diagnostic analysis of miRNAs in HB, the pooled SEN and SPE were 0.76 (95% CI: 0.72–0.80) and 0.75 (95% CI: 0.70–0.80), respectively. Moreover, the pooled PLR was 2.79 (95% CI: 2.12–3.66), NLR was 0.34 (95% CI: 0.26–0.45), DOR was 10.24 (95% CI: 6.55–16.00), and AUC was 0.83, indicating that miRNAs had moderate diagnostic value in HB. For the prognostic analysis of miRNAs in HB, the abnormal expressions of miR-21, miR-34a, miR-34b, miR-34c, miR-492, miR-193, miR-222, and miR-224 in patients were confirmed to be associated with a worse prognosis. The pooled HR was 1.74 (95% CI: 1.20–2.29) for overall survival (OS) and 1.74 (95% CI: 1.31–2.18) for event-free survival (EFS), suggesting its potential as a prognostic indicator for HB. Conclusion: To the best of our knowledge, this is the first comprehensive systematic review and meta-analysis that examines the diagnostic and prognostic role of dysregulated miRNAs in HB patients. The combined meta-analysis results supported the previous individual finds that miRNAs might provide a new, noninvasive method for the diagnostic and prognostic analyses ofHB.

scholarly journals Incremental Value of Left Ventricular Mechanical Dyssynchrony Assessment by Nitrogen-13 Ammonia ECG-Gated PET in Patients With Coronary Artery Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Danzha Zheng ◽  
Yanyun Liu ◽  
Lei Zhang ◽  
Fan Hu ◽  
Xubo Tan ◽  
...  
Keyword(s):  
Myocardial Viability ◽  
Diagnostic Value ◽  
Mechanical Dyssynchrony ◽  
Left Ventricular ◽  
Viable Myocardium ◽  
Cardiac Events ◽  
Nitrogen 13 Ammonia ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease

Background: Phase analysis is a technique used to assess left ventricular mechanical dyssynchrony (LVMD) in nuclear myocardial imaging. Previous studies have found an association between LVMD and myocardial ischemia. We aim to assess the potential diagnostic value of LVMD in terms of myocardial viability, and ability to predict major adverse cardiac events (MACE), using Nitrogen-13 ammonia ECG-gated positron emission tomography (gPET).Methods: Patients with coronary artery disease (CAD) who underwent Nitrogen-13 ammonia and Fluorine-18 FDG myocardial gPET were enrolled, and their gPET imaging data were retrospectively analyzed. Patients were followed up and major adverse cardiac events (MACE) were recorded. The Kruskal-Wallis test and Mann-Whitney U test were performed to compare LVMD parameters among the groups. Binary logistic regression analysis, receiver operating characteristic (ROC) curve analysis, and multiple stepwise analysis curves were applied to identify the relationship between LVMD parameters and myocardial viability. Kaplan–Meier survival curves and the log-rank test were used to look for differences in the incidence of MACE.Results: In total, 79 patients were enrolled and divided into three groups: Group 1 (patients with only viable myocardium, n = 7), Group 2 (patients with more viable myocardium than scar, n = 33), and Group 3 (patients with less viable myocardium than scar, n = 39). All LVMD parameters were significantly different among groups. The median values of systolic phase standard deviation (PSD), systolic phase histogram bandwidth (PHB), diastolic PSD, and diastolic PHB between Group 1 and Group 3, and Group 2 and Group 3 were significantly different. A diastolic PHB of 204.5° was the best cut-off value to predict the presence of myocardial scar. In multiple stepwise analysis models, diastolic PSD, ischemic extent, and New York Heart Association (NYHA) classification were independent predictive factors of viable myocardium and myocardial scar. The incidence of MACE in patients with diastolic PHB > 204.5° was 25.0%, higher than patients with diastolic PHB <204.5° (11.8%), but the difference was not significant.Conclusions: LVMD generated from Nitrogen-13 ammonia ECG-gated myocardial perfusion imaging had added diagnostic value for myocardial viability assessment in CAD patients. LVMD did not show a definite prognostic value.

scholarly journals P1391 Global longitudinal strain in chronic asymptomatic aortic regurgitation: a meta-analysis

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D De Campos ◽  
R Teixeira ◽  
A Botelho ◽  
C Saleiro ◽  
J Lopes ◽  
...  
Keyword(s):  
Aortic Regurgitation ◽  
Longitudinal Strain ◽  
Meta Analysis ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Symptom Development ◽  
Ventricular Ejection Fraction ◽  
Asymptomatic Patients ◽  
All Cause Mortality

Abstract BACKGROUND Previous studies have shown that left ventricle global longitudinal strain (GLS) assessed with 2D-speckle tracking echocardiography, is an independent predictor of outcome in asymptomatic moderate to severe chronic aortic regurgitation (AR) patients. OBJECTIVES To assess GLS impact on mortality and need for aortic valve replacement (AVR) or symptom development in chronic asymptomatic AR patients and preserved left ventricular ejection fraction (LVEF). METHODS A literature search was performed according with these key terms "aortic regurgitation" and "longitudinal strain." The primary endpoint was all-cause mortality. Secondary end-points were: a composite of all-cause mortality, need for AVR or symptom development; and only AVR plus symptom development. Data was pooled using random-effects meta-analysis models. Pooled Hazard Ratio (HR) was performed using its log transformation and inverse variances as weights were then calculated for each study . RESULTS Six studies were included, with a total of 1,571 asymptomatic patients with at least moderate AR and preserved LVEF. There were 996 events (death, AVR, symptom development) reported during follow-up. Pooled adjusted mortality HR tended to be higher for patients with worse GLS (1.14 [0.96–1.35], P = 0.13, I2 51%). GLS performed better in predicting AVR or symptom development (mean difference -0.72 [-1.29, -0.15], P = 0.01, I2 88%), with an estimated HR of 1.36 ([1.01–1.84], P = 0.04, I2 65%). CONCLUSIONS In asymptomatic chronic moderate to severe AR patients, impaired GLS was associated with adverse cardiac outcomes. Left ventricular GLS may offer incremental value on risk stratification as well as on decision-making. Abstract P1391 Figure 1

scholarly journals Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

2019 ◽  
Author(s):  
Lei Peng ◽  
Jinze Li ◽  
ZhengJu Ren ◽  
Hong De Cao ◽  
Lujia He ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Telomerase Activity ◽  
Low Grade ◽  
Significant Difference ◽  
Sensitivity Specificity

Abstract Background: This study aimed to evaluate the diagnostic value of telomerase activity (TA) for bladder cancer (BC) by meta-analysis. Methods: We conducted a systematic search of studies published on PubMed, Embase, and Web of Science up to June 1, 2019. We used Stata 15 and Review Manager 5.3 for calculations and statistical analysis. Results: To evaluate the diagnostic value of TA for BC, we performed a meta-analysis on 22 studies, with a total of 2867 individuals, including sensitivity, specificity, positive and negative likelihood ratio (PLR, NLR), diagnostic odds ratio (DOR), and 95% confidence intervals (CIs). The pooled parameters were calculated from all studies and we found a sensitivity of 0.79 (95% CI: 0.72 – 0.84), a specificity of 0.91 (95% CI: 0.87–0.94), a PLR of 8.91 (95% CI: 5.91–13.43), an NLR of 0.24 (95% CI: 0.15–0.37), a DOR of 37.90 (95% CI: 23.32–61.59), and an AUC of 0.92 (95% CI: 0.90–0.94). We also conducted a subgroup analysis based on the different stages and grades of BC. Results from the subgroup analysis showed that there was no significant difference in TA in either high and low stages of BC, but that low-grade tumours had a lower TA than high-grade tumours. Conclusions: In BC, there is a high overall diagnostic value for TA, and this could provide an alternative to cystoscopy for staging and grading of tumours. The tumor characteristics also showed a good diagnostic value

scholarly journals Diagnostic value of Telomerase Activity in patients with Bladder cancer: a meta-analysis of diagnostic test

2019 ◽  
Author(s):  
Lei Peng ◽  
Lujia He ◽  
ZhengJu Ren ◽  
Hong De Cao ◽  
Jinze Li ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Telomerase Activity ◽  
Low Grade ◽  
Significant Difference ◽  
Meta Analyses ◽  
Sensitivity Specificity

Abstract Background This article aims to evaluate the diagnostic value of telomerase activity (TA) in bladder cancer (BC) by meta-analysis of diagnostic tests. Methods We conducted a systematic search of articles published on PubMed, Embase, and Web of Science up to June 1, 2019.Stata 15 and Review Manager 5.3 were used for calculation and statistical analyses. Results We use the sensitivity, specificity, positive and negative likelihood ratio (PLR,NLR),diagnostic odds ratio (DOR) and 95% confidengce intervals (CIs) to evaluate the diagnostic value of TA for BC. 22 studies were included in the meta- analyses, with a total of 2867 individuals. The pooled parameters are calculated from all studies: sensitivity of 0.79(95%CI:0.72-0.84), specificity of 0.91(95%CI:0.87-0.94), PLR of 8.91(95%CI:5.91-13.43),NLR of 0.24(95%CI:0.15-0.37), DOR of 37.90(95%CI:23.32-61.59), AUC of 0.92(95%CI:0.90-0.94). We also conducted subgroup based on different stages and grades. Results from subgroup analysis showed that there was no significant difference in TA during the high and low stages BC, but low-grade tumors have lower TA than high-grade tumors. Conclusions For the diagnosis of BC, the overall diagnostic value of TA is high, and is expected to be an alternative to cystoscopy for different staging and grading. The tumor also has a very good diagnostic value.

scholarly journals Short-Term Effects of Verapamil and Diltiazem in the Treatment of No Reflow Phenomenon: A Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Lan Wang ◽  
Zhong Cheng ◽  
Ye Gu ◽  
Dingfeng Peng
Keyword(s):  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Events ◽  
Ventricular Ejection Fraction ◽  
Timi Frame Count ◽  
No Reflow ◽  
Adverse Cardiac Events ◽  
No Reflow Phenomenon ◽  
And Control

Currently, there is still a lack of an optimal treatment for no reflow phenomenon (NRP). We analyzed the efficacy and safety of using nondihydropyridine calcium channel antagonists (NDHP, verapamil/diltiazem) in patients suffering from NRP. Eight RCTs with 494 participants were eligible for analysis. The pooling analysis showed that intracoronary verapamil/diltiazem injection significantly decreased the occurrence of the coronary NRP (RR: 0.3, 95% CI: 0.16–0.57;P=0.0002) and reduced corrected thrombolysis in myocardial infarction (TIMI) frame Count (WMD = −9.24, 95% CI −13.91–4.57;P=0.0001) in patients with NRP. Moreover, verapamil/diltiazem treatment showed superiority in reducing wall motion index (WMI) compared to the control at day 1 (WMD = 0.11, 95% CI: 0.02–0.20;P=0.02) (P<0.05). There was also a significantly greater decline at occurrence of the major adverse cardiac events between verapamil/diltiazem and control groups (WMD: 0.4, 95% CI: 0.19–0.84;P=0.02). However, using verapamil/diltiazem did not provide additional improvement of left ventricular ejection fraction post procedure (at 7 days, WMD, 0.1; 95% CI, −2.43–2.63;P=0.94; at 30 days, WMD, 0.42; 95% CI, −2.09–2.92;P=0.75). NDHP use is beneficial in attenuating NRP and reducing 6-month MACEs in patients with NRP.

scholarly journals The Accuracy of Single MicroRNAs in Peripheral Blood to Diagnose Ovarian Cancer: An Updated Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yubao Cui ◽  
Shanchao Hong ◽  
Xuming Zhu
Keyword(s):  
Ovarian Cancer ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
The United States ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Summary Receiver Operating Characteristic ◽  
Carbohydrate Antigen 125

Background. Ovarian cancer is the 5th leading cause of death of women due to cancer in the United States. Although carbohydrate antigen 125 has a moderate diagnostic utility, the phenomenon of false-positive exists. As novel effective biomarkers, some single microRNAs (miRNAs) have diagnostic values for ovarian cancer, but the results lack consistency. In order to precisely and comprehensively assess the diagnostic value of single miRNAs for ovarian cancer, a meta-analysis is performed. Methods. Articles concerning the diagnostic value of single miRNAs for ovarian cancer were searched from databases. The pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) with the corresponding 95% confidence interval (CI) were calculated. Area under curve (AUC) of the summary receiver-operating characteristic (SROC) curve was also calculated. Results. In total, 22 studies including 8 kinds of single miRNAs were enrolled in this paper (6 studies for miR-200c, 3 studies for miR-200a and miR-200b, and 2 studies for miR-205, miR-145, miR-141, miR-429, and miR-125b). For miR-200c, the pooled SEN and SPE were, respectively, 0.768 (95% CI: 0.722-0.811) and 0.680 (95% CI: 0.624-0.732); the pooled PLR and NLR were, respectively, 2.897 (95% CI: 1.787-4.698) and 0.340 (95% CI: 0.276-0.417); the pooled DOR was 8.917 (95% CI: 4.521-17.587); and AUC of SROC curve was 0.815. For miR-200a, the pooled SEN and SPE were, respectively, 0.759 (95% CI: 0.670-0.833) and 0.717 (95% CI: 0.627-0.795); the pooled PLR and NLR were, respectively, 3.129 (95% CI: 0.997-9.816) and 0.301 (95% CI: 0.207-0.437); the pooled DOR was 11.323 (95% CI: 3.493-36.711); and AUC of SROC curve was 0.857. For miR-200b, the pooled SEN and SPE were, respectively, 0.853 (95% CI: 0.776-0.912) and 0.775 (95% CI: 0.690-0.846); the pooled PLR and NLR were, respectively, 4.327 (95% CI: 0.683-27.415) and 0.225 (95% CI: 0.081-0.625); the pooled DOR was 19.678 (95% CI: 2.812-137.72); and AUC of SROC curve was 0.90. For miR-205, miR-145, miR-141, miR-429, and miR-125b, each diagnostic value should be interpreted cautiously because only two studies were included. Conclusions. miR-200c, miR-200a, and miR-200b can be useful diagnostic biomarkers for ovarian cancer. More related studies are needed for miR-205, miR-145, miR-141, miR-429, and miR-125b.

scholarly journals Cardiomyopathy in Pregnancy: A Review Literature

2021 ◽  
Vol 2 (1) ◽  
pp. 16-24
Author(s):  
Ayu Asri Devi Adityawati ◽  
Anna Fuji Rahimah ◽  
Heny Martini ◽  
Cholid Tri Tjahjono
Keyword(s):  
Left Ventricular Systolic Dysfunction ◽  
Systolic Dysfunction ◽  
Developed Countries ◽  
Left Ventricular ◽  
Review Literature ◽  
Cardiac Complications ◽  
Class Iii ◽  
Cardiac Events ◽  
Asymptomatic Patients ◽  
In Pregnancy

BACKGROUND: Pregnancy is an experience that many women can achieve. Pregnancy is generally well tolerated in asymptomatic patients with cardiomyopathies but in restrictive form cardiomyopathy, pregnancy cannot be tolerated because of poor prognosis. Prior cardiac events, poor functional class (New York Heart Association class III or IV), or advanced left ventricular systolic dysfunction are present, the risk of maternal cardiac complications during pregnancy are markedly increased. Worsening of the clinical condition can occur during pregnancy, despite intensive medical treatment. Although the incident of cardiovascular disease is present 0.5-4% in developed countries, our knowledge about various of cardiomyopathy and pregnancy should be updateable. CONCLUSION: Our literature provide three types of cardiomyopathy in pregnancy with an example condition for each type that relevant during pregnancy. Peripartum cardiomyopathy is the most common form of cardiomyopathy occured in pregnancy therefore a thorough review is needed to give best outcome for pregnancy. Arryhtmia is the commonnest form in hypertrophic cardiomyopathy which need to be regularly monitored and measure should be taken if the arryhtmia is life threatening for mother and the child. Cardiac amyloidosis is the common form of restrictive cardiomyopathy in pregnancy.

Abstract 14578: A Meta-analysis of Global Longitudinal Strain as a Predictor of Major Adverse Cardiac Events in Severe, Asymptomatic Aortic Stenosis With Preserved Ejection Fraction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Stefanie Furlan ◽  
Leonardo Tamariz ◽  
Robert Chait
Keyword(s):  
Aortic Stenosis ◽  
Ejection Fraction ◽  
Longitudinal Strain ◽  
Meta Analysis ◽  
Global Longitudinal Strain ◽  
Case Control ◽  
Left Ventricular ◽  
Cardiac Events ◽  
Case Control Studies ◽  
Reported Data

Introduction: The timing of surgical intervention in aortic stenosis (AS) is critical. Guidelines recommend aortic valve replacement in severe, asymptomatic AS with an ejection fraction (EF) less than 50%. Two-dimensional speckle tracking echocardiography is a relatively novel way to identify left ventricular dysfunction by measuring myocardial strain. Global longitudinal strain (GLS) is a measurement of deformation of the myocardium, and is considered a more sensitive marker for left ventricular dysfunction than EF. Hypothesis: Our aim was to determine if abnormal GLS predicts poor outcomes in severe, asymptomatic AS patients with a preserved EF. Methods: We conducted a meta-analysis and searched MEDLINE, EMBASE, Cochrane (2000 to 2015), supplemented by manual bibliographies of key relevant articles. We selected all cohort, cross-sectional, and case-control studies in which GLS was measured and major adverse cardiac events (MACE) were reported. In the case-control studies, we calculated the pooled standard mean difference (SMD) of GLS between those with MACE and those without MACE. In cohort studies, we calculated the pooled relative risk (RR) with the corresponding 95% confidence interval (CI) for incident MACE by using the fixed effects method. Results: Our search strategy identified 3 studies that met the inclusion criteria, and included 370 AS patients. Of the 3 studies, all reported data using a case-control design and 2 reported data using a cohort design. The median age of AS patients included was 72.6 years old, the median indexed aortic valve area was 0.44 (cm 2 /m 2 ), and the median ejection fraction was 64.2 (%). Of the 370 patients included in the analysis, 183 had MACE. Case-control studies revealed a pooled GLS SMD of 0.5 (95% CI: 0.30-0.69, p<0.01) for patients with MACE compared to those without MACE. Cohort studies revealed a RR of MACE of 2.07 (95% CI: 1.59-2.69, p<0.01) for those with abnormal GLS compared to those normal GLS. Conclusions: AS patients with a more positive global longitudinal strain value were more likely to have a major adverse cardiac event despite having a preserved EF and absence of symptoms. Therefore, if abnormal GLS is detected, earlier surgical intervention should be considered in severe, asymptomatic aortic stenosis.

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