Background

Recent studies have demonstrated that left ventricular myocardial work (MW) is incremental in diagnosis and prognostication compared with left ventricular ejection fraction and myocardial strain. The authors performed a meta-analysis of normal ranges of noninvasive MW indices including global work index, global constructive work, global wasted work, and global work efficiency and determined confounders that may contribute to variance in reported values.

Methods

Four databases (PubMed, Scopus, Embase, and the Cochrane Library) were searched through January 2021 using the key terms “myocardial work,” “global constructive work,” “global wasted work,” “global work index,” and “global work efficiency.” Studies were included if the articles reported LV MW using two-dimensional transthoracic echocardiography in healthy normal subjects, either in a control group or comprising the entire study cohort. The weighted mean was estimated by using the random-effect model with a 95% CI. Heterogeneity across included studies was assessed using the I² test. Funnel plots and the Egger regression test were used to assess potential publication bias.

Results

The search yielded 476 articles. After abstract and full-text screening, we included 13 data sets with 1,665 patients for the meta-analysis. The reported normal mean values of global work index and global constructive work among the studies were 2,010 mm Hg% (95% CI, 1,907-2,113 mm Hg%) and 2,278 mm Hg% (95% CI, 2,186-2,369 mm Hg%), respectively. Mean global wasted work was 80 mm Hg% (95% CI, 73-87 mm Hg%), and mean global work efficiency was 96.0% (95% CI, 96%-96%). Furthermore, gender significantly contributed to variations in normal values of global work index, global wasted work, and global work efficiency. No evidence of significant publication bias was observed.

Conclusions

In this meta-analysis, the authors provide echocardiographic reference ranges for noninvasive indices of MW. These normal values could serve as a reference for clinical and research use.

中文翻译：

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成人全球左心室心肌做功指数的正常范围：荟萃分析

背景

最近的研究表明，与左心室射血分数和心肌应变相比，左心室心肌做功（MW）在诊断和预后方面是递增的。作者对非侵入性 MW 指数的正常范围进行了荟萃分析，包括全局工作指数、全局建设性工作、全局浪费工作和全局工作效率，并确定了可能导致报告值差异的混杂因素。

方法

使用关键词“心肌工作”、“全球建设性工作”、“全球浪费工作”、“全球工作指数”和“全球工作”搜索了四个数据库（PubMed、Scopus、Embase 和 Cochrane 图书馆）至 2021 年 1 月效率。” 如果文章在健康正常受试者中使用二维经胸超声心动图报告了 LV MW，则纳入研究，无论是在对照组中还是在整个研究队列中。通过使用具有 95% CI 的随机效应模型估计加权平均值。使用I ²检验评估纳入研究的异质性。漏斗图和 Egger 回归检验用于评估潜在的发表偏倚。

结果

搜索产生了 476 篇文章。经过摘要和全文筛选，我们纳入了 13 个数据集和 1,665 名患者进行荟萃分析。研究中报告的全球工作指数和全球建设性工作的正常平均值分别为 2,010 mm Hg% (95% CI, 1,907-2,113 mm Hg%) 和 2,278 mm Hg% (95% CI, 2,186-2,369 mm Hg%) ， 分别。平均全球工作浪费为 80 mm Hg%（95% CI，73-87 mm Hg%），平均全球工作效率为 96.0%（95% CI，96%-96%）。此外，性别对全球工作指数、全球浪费工作和全球工作效率的正常值的变化有显着影响。没有观察到显着发表偏倚的证据。

结论

在这项荟萃分析中，作者提供了 MW 无创指数的超声心动图参考范围。这些正常值可以作为临床和研究使用的参考。