JMIR Res Protoc. 2026 Aug 7;15:e71380. doi: 10.2196/71380.
ABSTRACT
BACKGROUND: Brain natriuretic peptide (BNP) and global longitudinal strain (GLS) are emerging biomarkers used to risk-stratify patients with asymptomatic severe aortic regurgitation (AR) and preserved ejection fraction (EF). Although numerous clinical trials have investigated the efficacy of these biomarkers in patients with aortic stenosis, only a limited number have examined these biomarkers in patients with AR. Therefore, the proposed systematic review and meta-analysis seeks to assess the prognostic value of BNP and/or GLS in patients with severe asymptomatic AR and preserved EF.
OBJECTIVE: This is a protocol for a systematic review and meta-analysis that will aggregate and synthesize high-quality clinical data on the usefulness of BNP and GLS as prognostic indicators for asymptomatic severe AR with preserved EF. By providing a comprehensive review, our study will have a significant impact in determining surgical candidacy in this patient population.
METHODS: In accordance with the PRISMA-S (Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension), which is an extension of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for reporting literature searches in systematic reviews, a comprehensive search of databases, including PubMed, Cochrane, and Embase, will be performed to retrieve peer-reviewed, English-language, observational, and experimental studies published from inception to November 2024. Studies that investigated patients aged ≥18 years with severe AR and preserved EF will be included. The National Heart, Lung, and Blood Institute tool will be used to assess the quality of the studies.
RESULTS: Search strategy development for this systematic review began in November 2024. A Peer Review of Electronic Search Strategies review of the search strategy with 2 academic librarians occurred in December 2024, and the final search strategy was finalized by the team of investigators in January 2025. Database queries and screening of studies began in January 2025 with title screening, followed by abstract screening in January and February 2025. Full-text screening took place from February to April 2025. Data extraction occurred between April and May 2025. Synthesis and risk of bias assessment occurred between April and May 2026, followed by data analysis between June and July 2026. Manuscript drafting will begin between June 2026 and July 2026, with manuscript writing and data dissemination continuing from May 2026 to August 2026. Findings will be submitted to a peer-reviewed journal by August 2026.
CONCLUSIONS: This systematic review will synthesize the existing evidence to determine the prognostic value of BNP and GLS in patients with asymptomatic severe AR and preserved EF, which could inform future clinical guidelines for the management of this population.
PMID:42566720 | DOI:10.2196/71380