Why the study?
How do left ventricular longitudinal, radial, and rotational function parameters assessed by speckle-tracking echocardiography differ between patients with moderate or severe aortic regurgitation and healthy controls?
How do left ventricular longitudinal, radial, and rotational function parameters assessed by speckle-tracking echocardiography differ between patients with moderate or severe aortic regurgitation and healthy controls?
Speckle-tracking echocardiography reveals that patients with moderate aortic regurgitation have left ventricular long-axis dysfunction with compensatory increased apical rotation, while severe disease is associated with reduced radial function and basal rotation.
Speckle-tracking may detect subclinical LV impairment in moderate AR; leaves open whether changes predict progression or warrant earlier intervention.
The aim of our study was to evaluate left ventricular (LV) longitudinal, radial, and rotational function and its relationship with conventional LV parameters of systolic and diastolic function in patients with aortic regurgitation (AR) by speckle-tracking echocardiography. MATERIAL AND METHODS. A total of 26 asymptomatic patients with moderate AR, 34 patients with severe AR, and 28 healthy controls were included into the study. LV rotation and longitudinal and radial strain were measured offline using speckle-tracking imaging. RESULTS. The systolic longitudinal strain (-18.3% [SD, 2.18%] vs. -21.0% [SD, 2.52%], P<0.05) and strain rate (-1.08 s(-1) [SD, 0.13 s(-1)] vs. -1.27 s(-1) [SD, 0.15 s(-1)], P<0.05) were significantly lower and apical rotation (11.3° [SD, 4.99°] vs. 8.30° [SD, 4.34°], P<0.05) as well as rotation rate (82.72°/s [SD, 28.24 °/s] vs. 71.00°/s [SD, 28.04 °/s], P<0.05) were significantly higher in the patients with moderate AR compared with the control patients. The LV systolic basal rotation, systolic radial strain, and diastolic radial strain rate were significantly reduced in the patients with severe AR compared with the control patients. The global longitudinal, radial strain, and LV systolic diameter were the independent predictors of LV ejection fraction in the patients with AR (R(2)=0.77). The LV systolic basal rotation in the control patients, diastolic longitudinal strain rate and systolic longitudinal strain in the patients with moderate and severe AR, respectively, were independent predictors of LV diastolic filling. CONCLUSIONS. LV long-axis dysfunction with an increased apical rotation was present in the patients with moderate AR, while LV radial function and systolic basal rotation were found to be reduced in more advanced disease. LV diastolic filling depended on diastolic and systolic LV strain and rotation components in the patients with AR.
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Mizarienė et al. (2012) studied this question.
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