Evaluation Of Left Ventricular Function Of Severe Aortic Stenosis And Post-TAVI By Using Two-Dimensional Speckle Tracking And Myocardial Work

Objective:Transcatheter Aortic Valve Implantation(TAVI)is currently the first choice for intervention therapy for patients with severe aortic stenosis(AS)at high risk of surgery.This article combines two-dimensional speckle tracking imaging technology and myocardial work technology to evaluate left ventricular myocardial systolic function between the severe AS patients with preserved left ventricular ejection fraction(LVEF)and post-TAVI,which would provide better diagnosis and prognostic evaluation indicators for the clinic.Methods:This research selected two groups as the research subjects,which One is the twenty-one severe AS patients who underwent TAVI surgery with preserved ejection fraction,and the another one is the twenty healthy adults with matching age as the control group,to obtain the basic clinical data,collect the ultrasound images and conventional ultrasound data of the control group,within forty-eight hours before TAVI,one week and three months after TAVI,and apply 2DSTI obtaining the global,layered and segmental myocardial longitudinal strain and circumferential strain,global radial strain,myocardial work indexes(global work index(GWI),global constructive work(GCW),global wasted work(GWW)and global work efficiency(GWE).The left ventricular ejection fraction(LVEF)was obtained by using Simpson analysis.Then all the results use the statistical analysis and comparation.Results:It’s no significant difference in the LVEF between the control group,pre-TAVI and post-TAVI(P>0.05).Compared with the control group,the global,layered and segment strains of the left ventricle in severe AS were reduced(P<0.05),GWE decreased(P<0.05),GWW increased(P<0.05),GWI and GCW had no significant difference(P>0.05).Compared with the pre-TAVI,only GWI and GCW decreased at one week post-TAVI(P<0.05),longitudinal and circumferential strain had no significant changes(P>0.05).Compared with the pre-TAVI,the global,stratified and segmental longitudinal strain is significantly increased at three months post-TAVI(P<0.05),circumferential strain had no significant changes(P>0.05).Compared with one week after TAVI,GWI,GCW and GWE increased at three months post-TAVI(P<0.05).Conclusions:Two-dimensional speckle tracking technology and myocardial work could not only early evaluate the subclinical systolic dysfunction of left ventricular myocardium in severe AS patients with preserved ejection fraction,but also follow up assessment of the improvement of left ventricular myocardial systolic function in post-TAVI,providing a more accurate index for clinical evaluation of the efficacy of TAVI surgery.