Key result
Asymptomatic severe aortic stenosis with preserved LVEF is linked to reduced LVGLS compared to controls.
Why the study?
Severe aortic stenosis causes impaired coronary flow reserve and longitudinal shortening, prompting the evaluation of LV global longitudinal systolic strain to identify subclinical LV dysfunction and its correlation with NT pro-BNP in asymptomatic severe AS with preserved LVEF.
Does LVGLS imaging detect subclinical LV dysfunction and correlate with NT pro-BNP in asymptomatic patients with severe aortic stenosis and preserved ejection fraction?
Case-Control (n=63)
Does LVGLS imaging detect subclinical LV dysfunction and correlate with NT pro-BNP in asymptomatic patients with severe aortic stenosis and preserved ejection fraction?
p-value: p=<.001
LVGLS imaging can reliably detect subclinical left ventricular dysfunction and correlates with NT-proBNP levels in asymptomatic patients with severe aortic stenosis and preserved ejection fraction.
LVGLS may detect subclinical dysfunction in asymptomatic severe AS; leaves open whether it refines risk stratification or intervention timing.
Introduction Left ventricular (LV) hypertrophy and high filling pressure in severe aortic stenosis (AS) cause impairment in coronary flow reserve. This results in LV myocardial ischemia, resulting in impairment in longitudinal shortening. Aim To study the role of LV global longitudinal systolic strain (LVGLS) imaging in identifying subclinical LV dysfunction and to determine the correlation between LVGLS and N-terminal pro-B-type natriuretic peptide (NT pro-BNP) in asymptomatic patients having severe AS and preserved left ventricle ejection fraction. Methodology This study included 33 asymptomatic patients with severe AS and 30 age- and sex-matched control groups. The ejection fraction was measured using the modified Simpson technique. LVGLS was measured with a two-dimensional speckle tracking analysis on apical 2, 3, and 4 chamber views. Results LVGLS was significantly reduced in asymptomatic severe aortic stenosis with normal ejection fraction compared to the normal control group without aortic stenosis ( P < .001). There is a positive correlation between impairment of LVGLS and left ventricular mass index (LVMI), the pressure gradient across the aortic valve, and the valve area. There is a linear correlation between NT pro-brain natriuretic peptide (BNP) and LVGLS ( r value 0.447); as the LVGLS decreases, NT pro-BNP increases. Conclusion LVGLS can be used as a reliable indicator for the detection of subclinical LV dysfunction in asymptomatic severe aortic stenosis patients with preserved ejection fraction.
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Dinaraj et al. (2025) conducted a case-control in Asymptomatic severe aortic stenosis (n=63). Asymptomatic severe aortic stenosis vs. Normal control group without aortic stenosis was evaluated on Left ventricular global longitudinal systolic strain (LVGLS) (p=<.001). Asymptomatic severe aortic stenosis with preserved ejection fraction was associated with significantly reduced left ventricular global longitudinal systolic strain compared to controls (P<.001).
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