Abstract 227: Normalized Global Systolic Circumferential Strain Can Detect Incipient Myocardial Dysfunction in Patients With Chronic Aortic Regurgitation
INTRODUCTION This study assessed whether global circumferential strain could disclose incipient myocardial dysfunction due to chronic aortic regurgitation (AR) with a consequent potential of being a means for optimal timing of valve surgery in patients with AR.
METHODS: Thirty-four patients with chronic severe AR referred for aortic valve replacement were studied along with 31 healthy controls. Myocardial circumferential strain was measured by 2-dimensional speckle tracking echocardiography (2D-STE) in addition to standard assessment of LV volumes and ejection fraction (LVEF). Strain was normalized by end-diastolic volume in order to correct for the volume dependency of deformation.
RESULTS: Global systolic circumferential strain was similar in the AR patients before surgery as compared to the healthy controls (−22.4±2.9 % vs. −22.6±2.5 %, p=0.74). This was the case also for LVEF (58±5 % vs. 59±6 % p=0.52). In contrast, normalized global circumferential strain was significantly lower in the AR patients (−0.10±0.05 vs. −0.24±0.08, p<0.01). Moreover, normalized strain increased after surgery indicating improved LV function (−0.13±0.07, p<0.01), although still reduced as compared to controls (p<0.01).
CONCLUSIONS: The study demonstrated markedly reduced normalized global circumferential strain in chronic AR patients with still preserved LVEF. Thus, normalized circumferential strain seems to be more sensitive in identifying myocardial impairment in AR patients than traditional measures and might consequently be of importance for improved timing of valve surgery.