Forty-seven patients referred for aortic valve replacement because of chronic AR were studied, along with 31 healthy controls. Myocardial deformation as determined by longitudinal, circumferential, and radial strain was calculated using two-dimensional speckle-tracking echocardiography technique, in addition to LV volumes, dimensions, and ejection fraction. Strain values were normalized to end-diastolic volume to correct for the volume dependency of deformation.
Global systolic longitudinal strain was significantly lower in patients with AR before surgery compared with the healthy controls (?7.5 ¡À 3.1 % vs ?2.1 ¡À 1.8 % , P < .01), while global circumferential strain and LV ejection fraction did not differ (?1.7 ¡À 3.4 % vs ?2.6 ¡À 2.5 % , P?= .22 and 59 ¡À 5 % vs 59 ¡À 6 % , P?= .59, respectively). However, differences between patients and controls were evident for both longitudinal and circumferential strain when normalized to end-diastolic volume (?.09 ¡À 0.04 vs ?.23 ¡À 0.08, P < .01, and ?.11 ¡À 0.05 vs ?.24 ¡À 0.08, P < .01, respectively). In contrast to their absolute values, both normalized variables demonstrated improvement in myocardial shortening after valve replacement (P < .01).
The study demonstrated reduced global longitudinal strain in patients with chronic AR with preserved LV ejection fractions. Global longitudinal strain might therefore disclose incipient myocardial dysfunction with a consequent potential for improved timing of aortic valve surgery.