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Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
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Incremental prognostic value of left ventricular global longitudinal strain in patients with aortic stenosis and

Kenya Kusunose1, Andrew Goodman1, Roosha Parikh1

  • 1From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.

Circulation. Cardiovascular Imaging
|October 17, 2014
PubMed

Insights

Left ventricular global longitudinal strain (LV-GLS) independently predicts mortality in patients with moderate to severe aortic stenosis (AS) and preserved ejection fraction. Adding LV-GLS to clinical factors significantly improves survival prediction in these AS patients.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiac Mechanics

Background:

  • Aortic stenosis (AS) is a significant cardiovascular condition.
  • Assessing mortality risk in AS patients with preserved ejection fraction is crucial.
  • The role of left ventricular global longitudinal strain (LV-GLS) in this population requires further investigation.

Purpose of the Study:

  • To evaluate the predictive value of LV-GLS for all-cause mortality in patients with moderate to severe and paradoxical severe AS.
  • To determine if LV-GLS offers incremental prognostic information beyond established clinical and echocardiographic parameters.

Main Methods:

  • A cohort of 395 patients with moderate to severe and paradoxical severe AS and preserved ejection fraction was studied.
  • Left ventricular global longitudinal strain (LV-GLS) was measured using Velocity Vector Imaging.
  • Cox proportional hazards models were used to assess the association between LV-GLS and all-cause mortality after risk adjustment.

Main Results:

  • In multivariable analysis, LV-GLS was an independent predictor of mortality (HR, 1.05; P<0.001).
  • Lower LV-GLS values (<-12.1%) were associated with significantly reduced survival.
  • Incorporating LV-GLS into a model with clinical parameters (Euroscore and NYHA class) significantly improved mortality prediction (χ(2) increase from 48 to 58; P<0.01).

Conclusions:

  • LV-GLS is an independent predictor of mortality in moderate to severe and severe AS patients with preserved LV ejection fraction.
  • LV-GLS provides incremental prognostic utility beyond standard clinical and echocardiographic assessments.
  • LV-GLS is a valuable tool for risk stratification in AS patients with preserved ejection fraction.
Abstract

Keywords:
aortic stenosisoutcomes

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