39. Speckle tracking echocardiography in patients with severe aortic stenosis and preserved ejection fraction undergoing aortic valve replacement

Abstract

Aim To evaluate myocardial strain by 2-dimensional speckle-tracking Echocardiography (2D-STE) in patients with severe aortic stenosis (AS) and preserved left ventricular (LV) ejection fraction (EF), before and after aortic valve replacement (AVR). Introduction Severe AS is characterized by chronic increase in the LV pressure and LV hypertrophy which lead to changes in the LV geometry. Impairment of the LV function in severe AS occurs despite of normal LV volumes and EF. Strain analysis by (2D-STE) can detect early and subtle changes of the LV function and can help in referring patients for earlier AVR to obtain better outcome. Methods 15 selected patients with severe AS (aortic valve area 2 ) and normal EF referred for surgical AVR (SAVR) or transcutaneous aortic valve implantation (TAVI). All patients had 2D transthoracic echocardiography and 2D-STE to assess both longitudinal and circumferential strain before and after AVR. Results the entire study cohort showed significant improvement in myocardial strain values. Global longitudinal strain (GLS −15.3 vs. −18.5) mean change of 2.1% and p value = 0.02 and global circumferential strain (GCS −28.9 vs. −31.9), mean change of 2.9% and p value = 0.036. Conclusions following AVR a significant improvement in LV myocardial strain both longitudinal and circumferential occurred. Strain analysis by 2D-STE can detect early and subtle changes in LV systolic function and might play a role in early intervention for severe AS with preserved ejection fraction.