Assessment of left ventricular function in aortic stenosis

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Mechanics

Background:

• Degenerative aortic stenosis (AS) is the most common valvular heart disease.
• Surgical valve replacement is the standard treatment for symptomatic severe AS.
• Left ventricular (LV) ejection fraction may not accurately reflect systolic function in the presence of LV hypertrophy.

Purpose of the Study:

• To review advanced echocardiographic techniques for assessing LV dysfunction in AS.
• To explore the role of myocardial deformation parameters in managing AS patients.
• To investigate the potential of these methods in guiding treatment decisions and predicting post-operative outcomes.

Main Methods:

• Review of current literature on echocardiographic assessment of LV function in AS.
• Focus on novel deformation parameters: myocardial strain, strain rate, and twist.
• Discussion of the pathophysiological basis of myocardial mechanics in chronic pressure overload.

Main Results:

• Asymptomatic patients with AS may have subclinical myocardial dysfunction despite preserved LV ejection fraction.
• Echocardiographic deformation parameters offer sensitive markers of global LV systolic function.
• These parameters may help identify patients who would benefit from early intervention.

Conclusions:

• Advanced echocardiographic techniques provide valuable insights into LV mechanics in AS.
• Quantifying myocardial strain, strain rate, and twist can aid in timing aortic valve replacement.
• These measurements may predict the improvement of LV function after valve implantation.