Abstract 3364: Preoperative Regional Myocardial Systolic Index Predicts Postoperative Left Ventricular Systolic Function in Patients with Chronic Aortic Regurgitation Assessed by Tissue Doppler Strain Rate Imaging
Background: Postoperative left ventricular (LV) systolic function is an important prognostic factor in patients with chronic aortic regurgitation (AR). Recently myocardial strain rate (SR) obtained from tissue Doppler echocardiography has been reported to provide reliable information regarding regional myocardial function. The purpose of this study was to investigate the value of preoperative regional myocardial peak systolic SR as a predictor of postoperative LV systolic function.
Methods: We studied 33 patients with chronic AR who underwent aortic valve replacement or valve repair. We performed standard and tissue Doppler echocardiography before and 17+/-7 days after surgical correction, and obtained left ventricular (LV) dimensions, LVEF, end systolic wall stress (WS), and peak systolic radial SR at the mid-ventricular level in the posterior wall.
Results: Surgical correction caused significant decrease in LV dimensions and WS and significant increase in peak systolic SR but no significant change in LVEF. Preoperative LVEF, systolic SR, end-systolic LV dimension and WS were significantly correlated with postoperative LVEF and multivariate analysis identified preoperative SR as the only independent predictor of postoperative LVEF. In Receiver Operating Characteristic curve analysis, preoperative SR < 1.92(/s) was the best predictor of postoperative LV dysfunction (LVEF < 55%) with a sensitivity of 87% and a specificity of 90%.
Conclusion: Lower preoperative systolic SR is significantly associated with postoperative LV systolic dysfunction and assessment of preoperative regional systolic function is useful to optimize the timing of surgery.