Syed Waleem Pasha1, Narasimha D. Pai2, Padmanabha Kamath3, Ramanatha L. Kamath4, Francis N.P. Monteiro5
BACKGROUND
Aortic stenosis (AS) is the most common, single, native valvular heart disease in
adult population. The purpose of this study was to detect abnormalities in global
longitudinal strain (GLS) and strain rate using 2D - STI in patients with severe AS
and preserved left ventricular ejection fraction (LVEF). The effect of aortic valve
replacement (AVR) on changes in strain parameters 30 days after surgery was
also analysed.
METHODS
A total number of 60 patients aged more than 18 years with aortic valve disease
scheduled for surgical aortic valve replacement admitted in Department of
Cardiology, KMC hospital Mangalore, were included over a period of 18 months
from January 2017 to June 2018.
RESULTS
A total of 60 patients with severe AS, defined by an aortic valve area of < 1 cm²,
mean transaortic pressure gradient (? P) of > 40 mmHg and maximum aortic
velocity (Vmax) of > 4 m/sec were studied. Mean age of the study population was
63.5 years. 60 % of the population were males and 40 % being females. Most
common risk factor present in the study population was diabetes mellitus (DM).
83% of the patients in the study population had at least one symptom. Most
common symptom with which the patients presented was exertional dyspnoea. All
patients had normal left ventricle (LV) cavity dimensions and LVEF prior to surgery
with diastolic dysfunction being present in all patients. The LV ejection fraction is
not significantly altered. The aortic valve area calculated by continuity equation
has significantly increased post AVR with a significant reduction in transaortic peak
and means pressure gradients. Mean global longitudinal strain (GLS) improved
from -15.1 % to - 16.9 % (P < 0.001) and longitudinal strain rate improved from
-0.8 to -0.9/s (P < 0.001).
CONCLUSIONS
Global longitudinal strain and strain rate can be adequately measured by 2D
speckle-tracking imaging and can be used to detect subtle changes of myocardial
function in patients with severe AS with preserved LVEF.
