Abstract 15481: Regional Myocardial Systolic Function Using Transmural Myocardial Strain Profile Predicts Postoperative Left Ventricular Systolic Dysfunction in Chronic Aortic Regurgitation
Background: We have reported that preoperative peak systolic left ventricular (LV) strain rate predicts postoperative LV systolic dysfunction in chronic aortic regurgitation (AR). However, transmural property in myocardial deformation in AR has not been clear. Transmural myocardial strain distribution can be obtained as a form of transmural strain profile using a newly developed myocardial strain imaging system. Accordingly, the aim of this study was to investigate transmural strain profile in chronic AR and its predictive value for postoperative LV systolic dysfunction.
Methods: In 37 patients with chronic AR, we measured conventional echocardiographic indices and evaluated transmural strain profile in the LV posterior wall segment before and one year after surgical correction. The location of peak strain was measured as the percentage distance of the wall thickness from the endocardium toward the epicardium. We defined postoperative LV ejection fraction (EF) smaller than 50% as LV dysfunction.
Results: After surgical correction, LVEF significantly increased (54±8% to 60±9%, p<0.01) and the location of peak strain was significantly shifted from the epicardial side to the endocardial side (30±14% to 21±13%, p<0.01), although the peak strain value did not significantly change (50±16% to 56±27%). In addition, we found 5 patients with postoperative LV dysfunction. By simple liner regression analysis, preoperative peak strain value showed significant correlation with postoperative LVEF (p<0.01), but not preoperative LVEF and location of peak strain. Using receiver-operating characteristic curve analysis, the peak strain value of 35% predicted postoperative LV dysfunction with sensitivity of 80%, specificity of 84% and the area under curve of 0.78.
Conclusions: Preoperative peak strain value could predict postoperative LV dysfunction, but LVEF and the location of peak strain could not. Peak strain value using transmural strain profile is a useful method for evaluating myocardial function and predicting postoperative LV dysfunction in patients with chronic AR.
- © 2010 by American Heart Association, Inc.