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Published on: October 20, 2023
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Strain Assessment in Aortic Stenosis: Pathophysiology and Clinical Utility
Thomas Meredith1, David Roy2, Christopher Hayward1
1Department of Cardiology, St. Vincent's Hospital, Sydney, New South Wales, Australia; Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Summary
Global longitudinal strain, a sensitive echocardiographic measure, shows promise for assessing aortic stenosis severity and predicting outcomes after valve replacement surgery.
Area of Science:
- Cardiology
- Medical Imaging
- Echocardiography
Background:
- Current echocardiographic criteria for aortic stenosis severity lack recent updates despite imaging advancements.
- Focus is shifting towards quantifying the left ventricle's response to aortic stenosis.
- Global longitudinal strain (GLS) is emerging as a key metric.
Purpose of the Study:
- To review the pathophysiological basis of GLS in aortic stenosis assessment.
- To explore GLS's role in quantifying myocardial recovery post-aortic valve replacement.
- To evaluate GLS's prognostic discrimination capabilities.
Main Methods:
- Semiautomated calculation of GLS from standard 2D echocardiographic images.
- Review of existing research on GLS in aortic stenosis.
- Analysis of GLS as a prognostic marker.
Main Results:
- GLS is a sensitive indicator of hypertrophy-related left ventricular dysfunction.
- GLS demonstrates potential as a prognostic marker, independently and with existing systems.
- GLS may aid in assessing myocardial recovery and prognosis after surgery.
Conclusions:
- GLS offers a valuable tool for assessing left ventricular function in aortic stenosis.
- GLS has significant potential for improving prognostic accuracy in aortic stenosis patients.
- Further research into GLS applications post-aortic valve replacement is warranted.
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