426 Postsystolic shortening in patients with symptomatic aortic stenosis

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1 ; R. Arzanauskiene 1 ; G. Kaklauskaite 1 ; R. Verseckaite 1 ; Background: Myocardial postsystolic shortening (PSS) is considered a sen- sitive marker of myocardial ischaemia. In most patients with aortic stenosis (AS) left ventricular long axis excursion is reduced even in the presence of normal ejection fraction. Limited information exists regarding value of PSS in AS. Aim of the study was to investigate the presence and significance of PSS in patients with symptomatic AS. Methods: Seventy two patients (aged 65±9 yrs.) with symptomatic AS were studied. Left ventricular long axis function was assessed echocardio- graphicaly using tissue Doppler and digitized M-mode echocardi-graphy of mitral annulus motion. Results: PSS was present in 32 (44.4%) patients with AS. No statistically significant difference between groups with and without PSS was found in clinical data, left ventricular function and grade of AS. Frequency of signifi- cant coronary stenosis did not differ significantly in groups with and without PSS (32% vs 16%, p=0.11).The only significant finding was correlation be- tween duration of symptoms and amplitude of PSS (r=0.58, p<0.05). Mul- tiple regression analysis revealed best predictors of PSS amplitude (R 2 =0.56): thickness of posterior wall of the left ventricle, left atrium dimension, and systolic lateral velocity of mitral annulus (p<0.05). Conclusions: 1. Postsystolic shortening was present in 44.4 % of patients with symptomatic aortic stenosis and is associated with longer duration of symptoms. 2. In aortic stenosis postsystolic shortening amplitude is related to left ventricular hypertrophy and left atrial size. chamber stiffness (KLV) 0.12±0.11 mm Hg/ml. Prevalence of types of left ventricle remodeling was N - 11pts (8%), CR - 38 pts (30%), CH -- 60 pts (47%), EH - 19 pts (15%). In group of patients with excentric remodeling significantly higher were cESS and KLV and significantly lower was LVEF compared with patients without or with another type of LV remodeling. Midwall FS was significantly the lowest in patients with normal left ventricle than in patient with LV remodeling. There were no changes of echocardiographic Doppler parameters of aortic stenosis and diastolic function indices in differ-