Abstract OBJECTIVES Preoperative left atrial (LA) strain parameters measured by 2-dimensional speckle tracking echocardiography have been used to predict postoperative atrial fibrillation (POAF) after cardiac surgery. The aim of this meta-analysis was to determine whether preoperative LA strain parameters predict POAF after cardiac surgery. METHODS PubMed, Embase, Cochrane database, and Google Scholar were searched manually until 31st January, 2025. Studies where preoperative LA strain was used to predict POAF following cardiac surgery in adults were considered. Reviews, case series, case reports, and studies where patients were in preoperative atrial fibrillation were excluded. RESULTS Twenty-four observational studies involving 2242 patients were included. Preoperative LA reservoir strain was significantly lower in patients with POAF vs those without POAF (standardized mean difference (SMD) -2.37; 95% confidence interval (CI) -3.87 to -0.88; I2= 94.5%). Preoperative LA conduit (SMD -0.73; 95% CI: -1.06 to -0.39; I2= 41.5%) and contraction (SMD -1.04; 95% CI -1.81 to -0.27; I2= 92.2%) strain rates were significantly lower in patients with POAF while preoperative LA reservoir, conduit and contraction strain rates were not different in patients with POAF vs no POAF. Meta regression for heterogeneity in reservoir strain was significant for gender, vendor platform and filling pressures (E/e’). The cut-off value of LA reservoir strain for predicting POAF was 22 to 25% (area under curve 0.69, specificity 0.679 (95% CI : 0.645 to 0.711), sensitivity 0.713 (95% CI: 0.675 to 0.743)). CONCLUSIONS Preoperative LA reservoir, conduit, and contraction strain predict POAF in adults undergoing cardiac surgery.
Misra et al. (Thu,) studied this question.