Abstract 2251: Chronic Aortic Regurgitation: Early Detection of Left Ventricular Dysfunction by Global Systolic Strain
Purpose This study examined whether global longitudinal systolic strain by 2-dimensional speckle tracking echocardiography (2D-STE) could detect early onset of myocardial dysfunction in patients with chronic aortic regurgitation (AR).
Methods 36 patients referred to aortic valve replacement due to chronic AR were compared to 31 healthy age-matched controls. Left ventricular (LV) global systolic strain was assessed preoperatively by 2D-STE from conventional echocardiographic apical long-axis recordings. In addition, LV end diastolic diameter (EDD), end systolic diameter (ESD) and ejection fraction (EF) were measured.
Results LV dimensions were larger in the AR patients than in the normal individuals (EDD 67 ± 9 mm vs. 50 ± 5 mm (p<0.001) and ESD 45 ± 9 mm vs. 32 ± 4 mm (p<0.001), respectively). However, EF did not differ between the groups (58 ± 7 % vs. 59 ± 6 %, p=ns). In contrast, global systolic strain was markedly decreased in the AR patients as compared to the normal subjects (−17.4 ± 3.5 % vs. −22.1 ± 1.8 %, p<0.001).
Conclusions The study demonstrated reduced global systolic strain along with preserved EF in chronic AR patients. Thus, global strain seems to detect early LV dysfunction as opposed to EF. This might reflect that global strain is more sensitive to identify impaired myocardial function due to the volume load in AR. Consequently, global systolic strain might represent a potential means for improved timing of valve replacement.