Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve...

Area of Science:

• Cardiology
• Cardiovascular Surgery
• Echocardiography

Background:

• Severe aortic stenosis (AS) often necessitates surgical aortic valve replacement (SAVR).
• Left ventricular systolic dysfunction predicts adverse events post-SAVR, but many patients now undergo surgery with preserved function.
• Global longitudinal strain (GLS) is a potential marker for ventricular remodeling after SAVR in these patients.

Purpose of the Study:

• To evaluate changes in GLS after SAVR in patients with AS and preserved ejection fraction (EF).
• To compare GLS variations based on the severity of preoperative diastolic dysfunction.

Main Methods:

• 108 patients with AS and preserved EF undergoing SAVR were enrolled between June 2020 and March 2023.
• Echocardiography assessed GLS preoperatively, 7 days post-surgery, and 12 months post-surgery.
• Patients were stratified into Group A (diastolic dysfunction grade I) and Group B (grades II-III).

Main Results:

• Postoperative GLS decreased significantly (16 ± 4.3% to 12.8 ± 3.4%, p < 0.0001).
• After 12 months, GLS improved in both groups (Group A: 17.7 ± 3.4%, Group B: 15.7 ± 3.2%, p < 0.0001).
• Significant GLS improvement from baseline was observed only in Group A (mild diastolic dysfunction).

Conclusions:

• SAVR in patients with preserved LVEF causes an early GLS reduction, irrespective of diastolic dysfunction severity.
• A significant GLS recovery occurs by 12 months post-SAVR.
• Patients with mild diastolic dysfunction exhibit the most substantial GLS recovery.