Prognostic Value of Left Ventricular Deformation Parameters in Patients with Severe Aortic Stenosis: A Pilot Study of the Usefulness of Strain Echocardiography

• DOI: 10.1016/j.echo.2017.04.009
• Publication Date: 2017-06-07T17:31:20Z
• Authors: Lars Gunnar Klaeboe; Trine F. Haland; Ida S. Leren; Rachel M.A. ter B...; Pål H. Brekke; Helge Røsjø; Torbjørn Omland; Lars Gullestad; Svend Aakhus; Kristina H. Haugaa; Thor Edvardsen
• Keywords: Strain (injury)

Highlights•Strain echocardiography can detect altered myocardial mechanics in patients with AS.•Pronounced mechanical dispersion is associated worse prognosis AS.•Mechanical adds incremental prognostic value to LVEF, atrioventricular impedance, and global longitudinal strain.•Mechanical predicts mortality independently of LVEF AVR surgery status.AbstractBackgroundIn aortic stenosis, subtle alterations be detected by speckle-tracking before reduction left ventricular ejection fraction (LVEF).MethodsIn this prospective study, 162 stenosis an average valve area 0.7 ± 0.2 cm2 a mean 60 11% were included. Global strain (GLS) (SD time from Q/R on the electrocardiogram peak 16 segments) assessed using echocardiography, all-cause (n = 37) was recorded during 37 13 months follow-up.ResultsOverall, nonsurvivors had more pronounced GLS compared survivors (74 24 vs 61 18 msec [P < .01] −14.5 4.4% −16.7 3.6% .01], respectively). In 42 conservatively treated without surgical replacement, similar pattern observed versus (mechanical dispersion, 80 57 14 .01]; GLS, −14.0 4.9% −17.1 3.8% .04], Mechanical significantly (hazard ratio per 10-msec increase, 1.23; 95% CI, 1.07–1.42; P .01) Cox model adjusted for replacement treatment as time-dependent covariate. Continuous net reclassification improvement showed that valvulo-arterial impedance when adjusting total population.ConclusionIncreased may risk marker providing novel information stenosis.Graphical abstract