Abstract 4699: Preoperative Systolic Strain Rate Predicts Postoperative Left Ventricular Systolic Function in Patients with Chronic Aortic Regurgitation. 1 Year Follow Up Study
Postoperative left ventricular systolic function is an important prognostic factor in patients undergoing aortic valve replacement. Pre-operative myocardial deformation may be impaired without reduction in conventional indices like ejection fraction (EF) Strain rate (SR) imaging is sensitive in detecting regional systolic abnormalities and might allow the diagnosis of subclinical changes in LV function before surgery
Aim: to investigate the value of preoperative regional myocardial peak systolic SR as a predictor of postoperative LV systolic function.
Methods: We studied 30 patients (age 52±12) with severe chronic AR who underwent aortic valve replacement. A standard echo examination, extended with Tissue Doppler, was performed immediately before and 3, 6 and 12 months after surgery. To assess LV longitudinal deformation, SR data were acquired from the mid lateral (LW) and anterior (Ant) walls.
Results: Patients were divided into 2 groups based on post-operative EF: Group 1 with EF>50% and Group 2 with EF<50%. Group 1 had a significantly (p<0.005) higher preoperative SR (LW: −1.8± 0.38s-1; Ant: −1.8±0.4s-1) compared to Group 2 (LW: −1.0± 0.29s-1; Ant: −0.95± 0.4s-1. SR/EDV index showed also significant changes (p<0.001) at baseline between the groups. For detecting subclinical changes in deformation of the LW, a cut of value of the SR/EDV≤0.006 had 89% sensitivity and 93% specificity; for the Ant wall, SR/EDV≤0.005 had 88% sensitivity and 92% specificity;
Conclusion: A significant reduction in preoperative SR in patients with apparently preserved function (preoperative EF>50%) predicts post-operative LV dysfunction. SR imaging detects subclinical changes in LV function before they can be detected by global standard parameters and might thus be used to optimize the timing of surgery.