Heart failure & cardiomyopathies
Prognostic value of right ventricular longitudinal strain assessed by multimodal imaging in amyloidosis: systematic review and meta-analysis
Pooled result · All-cause mortality, 2D speckle-tracking RV-FWLS (per 1% lower)Result — go to the resultHazard ratio 1.10 95% CI 1.07–1.13Authors' conclusion
RV longitudinal strain parameters are powerful and robust predictors of adverse outcomes in amyloidosis.
Study context
- Population
- Patients with amyloidosisEighteen studies, mean age 68.8 ± 8.8 years, 57.3% with light-chain amyloidosis (AL)
- Participants
- 1,772 patients
- Comparison
- Pooled hazard ratios (HRs) per 1% lower right ventricular (RV) strain values
- Outcome
- All-cause mortality, 2D speckle-tracking RV-FWLS (per 1% lower)
- Follow-up
- Median : 2.6 (1.6) years
Methodological detailsinversely weighted random-effects meta-analysis
- Inversely weighted random-effects meta-analysis
Pooled result
As reported in the abstract
Hazard ratio
1.10
95% CI 1.07–1.13
Per 1% lower RV-FWLS
HR 1.10 (95% CI 1.07–1.13)
Per 1% lower RV-FWLS, as printed
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| Composite of all-cause death or heart failure hospitalization, 2D speckle-tracking RV-FWLS (per 1% lower) · median [inter-quartile range] follow-up: 1.5 [0.6] yearsI² = 0% | 1.06 (1.02–1.10) | |
| All-cause mortality, 2D speckle-tracking RV-GLS (per 1% lower)I² = 8.6% | 1.10 (1.07–1.13) | |
| All-cause mortality, CMR-based RV-GLS in AL amyloidosis (subgroup)I² = 0% | 1.06 (1.03–1.09) | |
| 0.512Hazard ratio (log scale) |
- Composite of all-cause death or heart failure hospitalization, 2D speckle-tracking RV free-wall longitudinal strain (RV-FWLS) (per 1% lower): 210 patients experienced the composite outcome
Subgroup and meta-regression analysis
- Consistency across amyloid subtypes, study design, presence of cardiac involvement, follow-up duration, and strain analysis software
Original publication
Prognostic value of right ventricular longitudinal strain assessed by multimodal imaging in amyloidosis: systematic review and meta-analysis. Eur Heart J Cardiovasc Imaging. Published 25 July 2025. doi:10.
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