Echocardiographic evaluation of left ventricular strain in severe aortic stenosis with therapeutic implications and risk stratification

Abstract

Degenerative aortic stenosis (AS) is an increasingly common acquired valvular heart disease in adults due to the extension of life expectancy in the population of developing countries. The occurrence of calcifications and associated severe aortic stenosis (SAS) increases with age and affects approx. 3-5% of people over 75 years of age. The basis for the decision on the date and type of therapy is echocardiographic evaluation of the severity of the AS and left ventricular (LV) function as well as clinical signs. It appears that the use of newer, more precise methods in echocardiography, especially in patients with preserved ejection fraction (pEF), may change our management in qualifying for valve replacement, especially in asymptomatic patients with SAS. The aim of this review study is echocardiographic strain analysis and evaluation of strain of LV myocardial fibers in patients with SAS, using the speckle tracking echocardiography (STE). This evaluation allows for risk stratification of a valve disease and the choice of the appropriate therapy method.

Assessment of subclinical left ventricular systolic dysfunction in patients with asymptomatic severe aortic stenosis with preserved left ventricular systolic function by three‐dimensional speckle tracking echocardiography

“…Furthermore, by the time LVEF is reduced, myocardial dysfunction has progressed, increasing the risk and poor outcome of surgery. 5,6 Myocardial strain imaging is a novel imaging modality for detecting subclinical LV systolic dysfunction in patients with preserved EF.…”

“…As a result, LVEF is an insufficient predictor of early myocardial abnormalities. Furthermore, by the time LVEF is reduced, myocardial dysfunction has progressed, increasing the risk and poor outcome of surgery 5,6 …”

Assessment of Cardiac Adverse Events following COVID-19 Vaccination by Speckle Tracking Echocardiography

“…The tissue tracking technique is a novel extension of the Doppler method that focuses on cardiac function, which allows identi cation of major cardiac changes in symptomatic individuals. Two-dimensional speckle tracking echocardiography (2D-STE) has been regarded as a promising tool for the evaluation of heart failure, coronary artery disease, myocardial dyssynchrony, valvular heart disease, and arrhythmia [11][12][13][14][15]. This modality is easily accessible, cost-effective, non-radiative, and non-invasive, with high sensitivity and speci city for LV functional assessment, and it can detect subclinical myocardial dysfunction early in the disease process [16][17][18].…”

Ejection Fraction and Espvr: A Study in the Mechanics of Left Ventricular Contraction

“…The importance of the longitudinal axis dynamics in prognostic and diagnostic applications has been stressed by several authors, facilitated by the introduction of new techniques of measurement like Doppler tissue imaging or speckle tracking echocardiography [20][21][22][23][26][27][28][29]. Particular attention was given to paradoxical low flow/low gradient aortic stenosis with preserved left ventricular EF according to the assumed definition EF > 0.5 [30][31][32][33][34][35]. It is now recognized that an early detection of signs of heart failure with preserved ejection fraction (HFpEF) or with normal ejection fraction (HFnEF) is an important clinical problem that may allow a better treatment of the underlying causes, delay may lead to complications with poor prognosis [36][37][38][39].…”