Abstract
Degenerative aortic stenosis (AS) is an increasingly common acquired valvular heart disease in adults due to the extension of life expectancy in the population of developing countries. The occurrence of calcifications and associated severe aortic stenosis (SAS) increases with age and affects approx. 3-5% of people over 75 years of age. The basis for the decision on the date and type of therapy is echocardiographic evaluation of the severity of the AS and left ventricular (LV) function as well as clinical signs. It appears that the use of newer, more precise methods in echocardiography, especially in patients with preserved ejection fraction (pEF), may change our management in qualifying for valve replacement, especially in asymptomatic patients with SAS. The aim of this review study is echocardiographic strain analysis and evaluation of strain of LV myocardial fibers in patients with SAS, using the speckle tracking echocardiography (STE). This evaluation allows for risk stratification of a valve disease and the choice of the appropriate therapy method.
Highlights
Degenerative aortic stenosis (AS) is an increasingly common acquired valvular heart disease in adults due to the extension of life expectancy in the population of developing countries
The aim of this review study is echocardiographic strain analysis and evaluation of strain of left ventricular (LV) myocardial fibers in patients with severe aortic stenosis (SAS), using the speckle tracking echocardiography (STE)
The consequences of increased afterload on LV should always be taken into account for the comprehensive assessment of patients with AS
Summary
Degenerative aortic stenosis (AS) is an increasingly common acquired valvular heart disease in adults due to the extension of life expectancy in the population of developing countries. The occurrence of calcifications and associated severe aortic stenosis (SAS) increases with age and affects approx. The consequence of an increase in AS is pressure overload and the resulting concentric left ventricular hypertrophy (LVH). At this stage, the cardiac output and filling pressure are normal. The left ventricular (LV) remodeling, in addition to stenosis, is influenced by other factors such as the age and sex of the patient, e.g., in women the process of faster calcification of the valve and quicker appearance of the disease symptoms are observed.[2] The other important factors are the following: genetic diversity in the renin-angiotensin system, comorbid coronary artery disease, arterial hypertension, and significant aortic regurgitation. In patients with SAS and associated hypertension, a reduced survival rate was observed.[3]
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