Myocardial function in aortic stenosis--insights from radial multilayer Doppler strain

• Published in: Cardiovascular ultrasound 2015-02, Vol.13 (1), p.8-8, Article 8
• Main Authors: Cramariuc, Dana, Gerdts, Eva, Hjertaas, Johannes Just, Cramariuc, Alexandru, Davidsen, Einar Skulstad, Matre, Knut
• Format: Article
• Language: English
• Subjects: Aged; Anisotropy; Aortic Valve Stenosis - complications; Aortic Valve Stenosis - diagnostic imaging; Aortic Valve Stenosis - physiopathology; Compressive Strength; Echocardiography, Doppler - methods; Elastic Modulus; Female; Humans; Male; Reproducibility of Results; Sensitivity and Specificity; Shear Strength; Stress, Mechanical; Tensile Strength; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; Ventricular Dysfunction, Left - physiopathology
• ISSN: 1476-7120; 1476-7120
• DOI: 10.1186/s12947-015-0001-z

Left ventricular (LV) radial tissue Doppler imaging (TDI) strain increases gradually from the subepicardial to the subendocardial layer in healthy individuals. A speckle tracking echocardiography study suggested this gradient to be reduced in parallel with increasing aortic stenosis (AS) severity. We used TDI strain in 84 patients with AS (mean age 73 ± 10 years, 56% hypertensive) for superior assessment of layer strain. 38 patients had non-severe and 46 severe AS by aortic valve area corrected for pressure recovery. Peak systolic radial TDI strain was measured in the subendocardial, mid-myocardial and subepicardial layers of the basal inferior LV wall, each within a region of interest of 2 × 6 mm (strain length 2 mm). Radial strain was lower in the subepicardial layer (33.4 ± 38.6%) compared to the mid-myocardial and subendocardial layers (50.3 ± 37.3% and 53.0 ± 40.0%, respectively, both p