Evaluation Of Left Ventricular Myocardial Function In Severe Aortic Stenosis Patients Underwent Aortic Valve Replacement With Preserved LVEF By Three-dimensional Speckle Tracking Echocardiography

Purpose:To observe the alternation of left ventricular myocardial function in severe aortic stenosis(AS)patients with preserved left ventricular(LV)ejection fraction(EF)before and after surgical aortic valve replacement(AVR)by three-dimensional speckle tracking imaging(3D-STI),The clinical value of such measurements was discussed.Methods:We enrolled 40 eligible patients with severe aortic stenosis and LVEF≥50%(AS group)and 40 normal controls(control group).Normal group underwent conventional echocardiography and 3D-STI measurement,while the AS group underwent conventional echocardiography and 3D-STI measurement at preoperative,1 week postoperative and 3 months postoperative,we obtained left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),interventricular septum thickness diameter(IVSd),left room posterior wall thickness diameter(LVPWd),left ventricular ejection fraction(LVEF),global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS),global area strain(GAS)strain and 3D-strain.Results:1.Compared with normal control group,severe AS patients,the left ventricular wall thickness and GCS were increased significantly(P<0.01),GLS,GRS,and 3D-Strain were decreased significantly(P<0.01),the others were no significant difference(P>0.05);2.Compared with preoperative,1 week postoperative,LVEF,GLS,GAS,GCS were decreased significantly(P<0.05),the others were significant difference(P>0.05);3 months postoperative:GLS、GRS and 3D-strain were increased significantly(P<0.01),GCS、IVSD and LVPWD were decreased significantly(P<0.01);3.Compared with 1 week postoperative:LVEF,GLS,GRS,GAS and 3D-strain were increased significantly(P<0.05),GCS、IVSD and LVPWD was decreased significantly(P<0.01),but 3 month postoperative,IVSD,LVPWD,GLS and GCS were still significant difference(P<0.05).Conclusion The left ventricular myocardial function have already changed in severe aortic stenosis patients with preserved LVEF,the alternation has a certain characteristic in 1 week and 3 months after aortic valve replacement,the 3 D-STI can evaluate it more accurately.