Key result
In patients with asymptomatic severe aortic stenosis, longitudinal strain of the lateral (-7.8% vs -10%, p=0.005) and posterior walls was significantly reduced compared to the interventricular septum.
Why the study?
This study aimed to investigate the correlation between severe aortic stenosis and segmental impairment of left ventricular global longitudinal strain using two-dimensional speckle tracking echocardiography in patients with preserved ejection fraction.
Does regional longitudinal strain differ between the lateral/posterior walls and the interventricular septum in asymptomatic patients with severe aortic stenosis and preserved LVEF?
Cross-Sectional (n=53)
Does regional longitudinal strain differ between the lateral/posterior walls and the interventricular septum in asymptomatic patients with severe aortic stenosis and preserved LVEF?
In asymptomatic patients with severe aortic stenosis and preserved LVEF, longitudinal strain is significantly more impaired in the lateral and posterior walls compared to the septum, suggesting regional strain could serve as a diagnostic and prognostic tool.
Answers are grounded in this paper and cite their sources.
Regional strain reductions in severe AS with preserved EF are hypothesis-generating; leaves open prognostic value and need for prospective validation.
INTRODUCTION: This study aims to investigate the correlation between severe aortic stenosis (sAS) and impairment of left ventricular global longitudinal strain (LVGLS) in particular segments, using two-dimensional speckle tracking echocardiography in patients with sAS and normal ejection fraction of left ventricle (LVEF). METHODS: The study included 53 consecutive patients with asymptomatic sAS and preserved LVEF. The regional longitudinal systolic LV wall strain was evaluated at the area opposite of the aorta as the median strain value of the basal, middle, and apical segments of the lateral and posterior walls and was compared to the average strain value of the interventricular septum (IVS) at the same views. RESULTS: LVGLS was decreased and was not statistically different between three- and four-chamber views (-12.5 ± 3.6 vs -11.4 ± 5.5%, p = 0.2). The average strain values of the lateral and posterior walls were statistically reduced compared to the average value of the IVS (lateral vs IVS: -7.8 ± 3.7 vs -10 ± 5.3%, p = 0.005, posterior vs IVS: -7.7 ± 4.2 vs -10.3 ± 3.8%, p < 0.0001). There was no significant difference between lateral and posterior walls (-7.8 ± 3.7 vs -7.7 ± 4.2%, p = 0.9). CONCLUSIONS: The strain of lateral and posterior walls of left ventricle, which lay just opposite to the aortic valve seem to be more reduced compared to other walls in patients with sAS and preserved LVEF possibly due to their anatomical position. This impairment seems to be the reason of the overall LVGLS reduction. Regional strain could be used as an extra tool for the estimation of the severity of AS as well as for prognostic information in asymptomatic patients.
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Kostakou et al. (2021) conducted a cross-sectional in Asymptomatic severe aortic stenosis with preserved LVEF (n=53). Lateral and posterior wall segments vs. Interventricular septum (IVS) was evaluated on Regional longitudinal systolic LV wall strain (p=0.005). In patients with asymptomatic severe aortic stenosis, longitudinal strain of the lateral (-7.8% vs -10%, p=0.005) and posterior walls was significantly reduced compared to the interventricular septum.
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