Degenerative aortic stenosis: prediction of poor prognosis by 2D left ventricular longitudinal strain in non-operated patients

Abstract

To investigate relationship between global longitudinal peak strain (GLPS) of the left ventricle (LV) and clinical routine echocardiographic (ECHO) and electrocardiographic (ECG) parameters in patients with non-operated aortic stenosis (AS) of all degrees. Also we evaluated the prognostic value of GLPS in patients with AS. Patients with AS (n = 80) and control patients (n = 49) matched by age, sex and main cardio-vascular diseases were examined. Examination included medical history, serum cholesterol and creatinine, ECG, routine ECHO, tissue Doppler imaging (TDI), and GLPS in apical views. Correlation analysis and unifactorial regression analysis for assessment of one year prognosis were performed in AS group. Average GLPS (GLPS_Avg) for whole LV was significant lower in AS group than in control group (-17.4 +/- 3.85 vs -19.3 +/- 3.99, p < 0.05). In AS group GLPS_Avg correlated with aortic valve area (r = 0.318, p = 0.004), LV ejection fraction (r = 0,305, p = 0,006), thickness of interventricular wall (r = -0.246, p = 0.028), QRS duration (r = -0.225, p = 0.045), and Cornell (r = -0.338, p = 0.003) and Gubner (r = -0.281, p = 0.013) ECG hypertrophy indexes. The GLPS_Avg below -13% was associated with risk of unfavorable one-year outcome in patients with AS. . GLPS for the whole LV correlated with early ECG and ECHO parameters of LV hypertrophy. GLPS has prognostic value for one-year outcomes in patients with degenerative non-operated AS.