Speckle Tracking Echocardiographic Assessment of Left Ventricular Function by Myocardial Strain Before and After...

Area of Science:

• Cardiology
• Echocardiography
• Cardiac Mechanics

Background:

• Aortic stenosis and regurgitation can cause subtle left ventricular (LV) dysfunction missed by standard echocardiography metrics like ejection fraction (EF).
• Speckle tracking imaging offers a more comprehensive assessment of LV function by measuring global longitudinal strain (GLS) and global circumferential strain (GCS).

Purpose of the Study:

• To evaluate the efficacy of speckle tracking analysis in assessing early left ventricular (LV) function changes in patients undergoing aortic valve replacement (AVR).
• To compare the recovery of GLS and GCS with ejection fraction (EF) post-AVR.
• To identify baseline strain parameters predictive of post-AVR recovery.

Main Methods:

• A prospective study included 94 patients with severe aortic stenosis (AS) or aortic regurgitation (AR) undergoing AVR, plus 15 healthy controls.
• Routine echocardiography and speckle tracking imaging were performed at baseline (pre-AVR) and at 1 week, 1 month, and 3 months post-AVR.

Main Results:

• In the aortic stenosis (AS) group, mean GLS improved from -10.9% to -19.4% (p<0.0001) and GCS from -17.3% to -21.4% (p<0.0001) by 3 months post-AVR.
• In the aortic regurgitation (AR) group, mean GLS improved from -12.6% to -19.4% (p<0.0001) and GCS from -15.3% to -21.7% (p<0.0001) by 3 months post-AVR.
• The recovery magnitude of GLS and GCS surpassed that of EF post-AVR.

Conclusions:

• Speckle tracking analysis effectively captures early left ventricular (LV) functional improvements after aortic valve replacement (AVR).
• Global longitudinal strain (GLS) and global circumferential strain (GCS) show greater recovery post-AVR compared to ejection fraction (EF).
• Suboptimal baseline GLS and GCS values predict reduced recovery, underscoring the need for earlier intervention.