Myocardial deformation in aortic valve stenosis: relation to left ventricular geometry.
OBJECTIVE
To assess left ventricular (LV) strain and displacement and their relations to LV geometry in patients with aortic stenosis (AS).


METHODS
Cross-sectional echocardiographic study in patients with AS. Peak circumferential, radial and longitudinal strain, and radial, longitudinal and transverse displacement were measured by 2D speckle tracking. Severity of AS was assessed from energy loss index (ELI). LV hypertrophy was present if LV mass/height(2.7) > or =46.7/49.2 g/m(2.7) in women/men and concentric LV geometry if relative wall thickness > or =0.43. LV geometry was assessed from LV mass/height(2.7) and relative wall thickness in combination. Setting Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.


METHODS
70 patients with AS (mean age 73+/-10 years, 54% women).


METHODS
None. Main outcome measures Association of regional and average LV myocardial strain and displacement with LV geometric pattern and degree of AS.


RESULTS
Average longitudinal strain was lower in the hypertrophy groups and correlated with higher LV mass index and relative wall thickness, lower stress-corrected mid-wall shortening and smaller ELI (all p<0.05). Average strain and displacement in other directions did not differ between geometric groups. In multivariate regression analysis, lower average longitudinal strain was associated with higher relative wall thickness (beta=0.15), lower ejection fraction (beta=-0.16), systolic blood pressure (beta=-0.16) and energy loss index (beta=-0.20) (all p<0.05) (R(2)=0.72). When relative wall thickness was replaced with LV mass, lower longitudinal strain was also associated with higher LV mass (beta=0.21, p<0.05) (R(2)=0.73).


CONCLUSIONS
In patients with AS, lower average longitudinal strain is related to higher LV mass, concentric geometry and more severe AS.
Cramariuc
Dana
D
Department of Heart Disease, Haukeland University Hospital, NO-5021, Bergen, Norway. dana.cramariuc@helse-bergen.no
Gerdts
Eva
E
Davidsen
Einar Skulstad
ES
Segadal
Leidulf
L
Matre
Knut
K
D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000473:pathology* / Q000503:physiopathology; D009202:Cardiomyopathies / Q000473:pathology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000473:pathology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013312:Stress, Physiological