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Myocardial deformation in aortic valve stenosis - relation to left ventricular geometry
  1. Dana Cramariuc (cramariuc_dana{at}yahoo.com)
  1. Institute of Medicine, University of Bergen, Department of Heart Disease, Haukeland University Hosp, Norway
    1. Eva Gerdts
    1. Institute of Medicine, University of Bergen, Department of Heart Disease, Haukeland University Hosp, Norway
      1. Einar Skulstad Davidsen
      1. Department of Heart Disease, Haukeland University Hosp, Norway
        1. Leidulf Segadal
        1. Department of Surgical Sciences, University of Bergen, Bergen, Norway
          1. Knut Matre
          1. Institute of Medicine, University of Bergen, Norway

            Abstract

            Objective: To assess LV strain and displacement and their relations to LV geometry in patients with AS.

            Design: Cross-sectional echocardiographic study in patients with aortic stenosis (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/height2.7 ≥46.9/ 49.2 g/m2.7 in women/men and concentric LV geometry if relative wall thickness >0.43. LV geometry was assessed from LV mass/height2.7 and relative wall thickness in combination.

            Setting: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.

            Patients: 70 patients with AS (mean age 73±10 years, 54% women).

            Interventions: 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 midwall 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 (β =0.15), lower EF (β =-0.16), systolic blood pressure (β =-0.16) and energy loss index (β =-0.20) (all p <0.05) (R2 =0.72). Replacing relative wall thickness with LV mass, lower longitudinal strain was also associated with higher LV mass (β =0.21, p <0.05) (R2 =0.73).

            Conclusions: In patients with AS, lower average longitudinal strain is related to higher LV mass, concentric geometry and more severe AS.

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