Abstract 664: Radial Systolic Strain Rate is a Reliable Predictor of Postoperative Left Ventricular Dysfunction in Chronic Aortic Regurgitation
(Background) There is still considerable controversy regarding predictors of postoperative left ventricular (LV) dysfunction in patients with chronic aortic regurgitation (AR). Many parameters have already been reported as predictors, but none seems to be superior and the accuracy of most has not been verified prospectively. Radial systolic strain rate (Ssr) has been reported to have the potential to detect myocardial impairment. The purpose of this study was to identify Ssr as a reliable predictor of postoperative LV dysfunction in patients with chronic AR.
(Methods) We studied consecutive 83 patients with chronic AR undergoing surgical correction. After retrospectively investigating Ssr as a predictor of postoperative LV dysfunction in 40 patients, we determined a cut-off point of Ssr for prediction of postoperative LV dysfunction. We prospectively verified the accuracy of Ssr in 43 patients with AR undergoing surgical correction. We preoperatively and postoperatively measured not only Ssr in the posterior wall using tissue Doppler imaging but also conventional parameters such as LV dimensions and LV ejection fraction (EF). Receiver-operating characteristic curve (ROC) was used to search for a predictor from these parameters.
(Results) In the retrospective study, we concluded that Ssr was the most reliable predictor since the area under the curve of Ssr was greater than that of the other parameters using the ROC analysis. With a cut-off value of Ssr < 1.7/s, sensitivity and specificity for detecting postoperative LVEF < 50% was 80% (8/10) and 83% (26/30), respectively. In the prospective study, Ssr < 1.7/s was the best predictor of postoperative LVEF < 50% with a sensitivity of 78% (14/18) and a specificity of 84% (21/25), respectively.
(Conclusions) We could verify the accuracy of Ssr as a predictor of postoperative LV dysfunction. Ssr is a reliable predictor of postoperative LV dysfunction, and is useful in optimizing surgical timing in patients with chronic AR.