Key result
Over a 6-month follow-up, patients with moderate-to-severe aortic stenosis exhibited significant worsening of left ventricular global longitudinal strain (-19.7 to -16.4, p=0.01).
Why the study?
The study was conducted to investigate changes in routine echocardiographic indices and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period.
Do routine echocardiographic indices and strain change over a 6-month follow-up period in patients with moderate-to-severe aortic stenosis?
Observational
Yes
Do routine echocardiographic indices and strain change over a 6-month follow-up period in patients with moderate-to-severe aortic stenosis?
In patients with moderate-to-severe aortic stenosis, left atrial dilatation and reduced global longitudinal strain occur early over a 6-month period even when left ventricular dimensions and function remain intact.
May signal early subclinical progression in moderate-severe AS; leaves open whether GLS or LA volume should guide surveillance or intervention.
BACKGROUND: The aim of this aortic stenosis registry was to investigate the changes of routine echocardiographic indices and strain in patients with moderate-to-severe aortic stenosis over a 6-month follow-up period. METHODS: . The enrolment took place from January to August 2017. We excluded patients with uncontrolled atrial arrhythmias, pulmonary hypertension or cardiomyopathies, as well as those with hemodynamically significant valvular disease other than aortic stenosis. We included patients who did not require intervention and who had a complete follow-up study. RESULTS: In patients with preserved ejection fraction, left ventricular mass has significantly increased between baseline and follow-up studies (218 ± 34 grams vs 253 ± 29 grams, p = 0.02). However, when indexed to body surface area, there was no significant difference. Left ventricular global longitudinal strain significantly decreased (-19.7 ± -4.8 vs (-16.4 vs -3.8, p = 0.01). Left atrial volume was significantly higher at follow-up (p = 0.035). Right ventricular basal diameter and mid-cavity diameter were greater at the follow-up (p = 0.04 and p = 0.035, respectively). Patients with low-flow low-gradient aortic stenosis had significantly lower global longitudinal strain (-12.3% ± -3.9% vs -19.7% ± -4.8%, p = 0.01). CONCLUSION: Left atrial dilatation is one of the first changes to take place in low-flow low-gradient aortic stenosis patients even when left ventricular dimensions and function remains intact. Global longitudinal strain is an important determinant of left ventricular systolic and diastolic dysfunction and right ventricular function is an important parameter of aortic stenosis assessment. Accordingly, our registry has further shed the light on these indices role as multisite follow-up of aortic stenosis.
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Anwer et al. (2020) conducted an observational in Moderate-to-severe aortic stenosis. Moderate-to-severe aortic stenosis vs. Baseline was evaluated on Changes of routine echocardiographic indices and strain. Over a 6-month follow-up, patients with moderate-to-severe aortic stenosis exhibited significant worsening of left ventricular global longitudinal strain (-19.7 to -16.4, p=0.01).
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