Echocardiographic evaluation of left ventricular strainin severe aortic stenosis with therapeutic implicationsand risk stratification

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.