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Surgically Induced Cardiac Volume Overload by Aortic Regurgitation in Mouse
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Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review

Diana deCampos1, Rogério Teixeira2,3, Carolina Saleiro1

  • 1Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Echo Research and Practice
|December 6, 2022
PubMed

Insights

Impaired left ventricular global longitudinal strain (GLS) in chronic aortic regurgitation (AR) patients correlates with adverse cardiac outcomes, including mortality and need for aortic valve replacement (AVR). GLS may aid in risk stratification for AR patients.

Area of Science:

  • Cardiology
  • Cardiac Mechanics
  • Clinical Outcomes Research

Background:

  • Chronic aortic regurgitation (AR) often presents with a prolonged asymptomatic phase.
  • Left ventricular mechanics, specifically global longitudinal strain (GLS), are increasingly recognized as important prognostic markers in AR.
  • Understanding GLS's role can improve management strategies for AR patients.

Purpose of the Study:

  • To systematically review and evaluate the impact of left ventricular GLS on mortality, need for aortic valve replacement (AVR), and disease progression in patients with chronic AR.
  • To synthesize existing evidence on the prognostic value of GLS in moderate to severe chronic AR.

Main Methods:

  • A systematic literature search was conducted using terms 'aortic regurgitation' and 'longitudinal strain'.
  • Included were randomized and non-randomized observational studies of chronic AR patients published between 2011 and 2018.
  • Six studies with a total of 1571 patients were analyzed, with a mean follow-up of 4.2 years.

Main Results:

  • Despite significant heterogeneity across studies, an impaired GLS was consistently associated with adverse cardiac outcomes.
  • Limited meta-analysis was possible due to variability in study design and endpoints.
  • Two studies reported on all-cause mortality, while others focused on GLS association with AVR and disease progression.

Conclusions:

  • Left ventricular GLS demonstrates potential as an incremental tool for risk stratification in chronic AR.
  • GLS measurement may assist clinicians in decision-making regarding patient management and intervention timing.
  • Further research is warranted to standardize GLS assessment and confirm its prognostic utility in AR.

Keywords:
aortic regurgitationaortic valve replacementglobal longitudinal strainoutcomes

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