Abstract 4698: Myocardial Radial Strain Rate Indicates Prognostic Significance in Asymptomatic Patients with Chronic Severe Aortic Regurgitation

Abstract

(Purpose) The purpose of this study was to investigate the prognostic value of myocardial systolic strain rate (Ssr) in the initial evaluation in asymptomatic patients with chronic severe aortic regurgitation (AR). (Methods) We studied 50 patients with severe AR and moderately dilated left ventricle (LV) who did not present with the operative indication in the initial evaluation. During an average of 24 months follow-up period, 15 patients underwent surgical corrections (group S) and remaining 35 did not require them (group M). In the initial echocardiographic examination, we obtained end-diastolic and end-systolic LV dimensions, radius to thickness ratio (R/T) and end-systolic wall stress (WS) from M-mode echocardiograms, and end-diastolic and end-systolic LV volume indices (EDVI and ESVI), LV ejection fraction (EF) using the modified Simpson’s method, and radial Ssr on the LV posterior wall using tissue Doppler imaging. We used a student t-test for 2 group comparison and the receiver-operating characteristic curve (ROC) to search for a predictor from parameters. (Results) There was no significant difference in EF, R/T, and WS between two groups in the initial evaluation. However, EDVI and ESVI in group S were significantly larger and Ssr in group S was significantly smaller than those in group M. In ROC analysis, we identified the area under the curve of Ssr was greater than that of the other variables. Kaplan-Meier analysis according to the cutoff value (Ssr 2.4/s) determined by analysis of ROC demonstrated a significantly lower operation-free rate in patients with Ssr < 2.4/s than in those with Ssr ≥ 2.4/s (p < 0.001). (Conclusions) Myocardial systolic strain rate is a valuable predictor for the progression of disease, and may be helpful for the risk assessment in the serial evaluation of asymptomatic patients with chronic AR.