Prognostic Value of Left Ventricular Deformation Parameters in Patients with Severe Aortic Stenosis:A Pilot Study of the Usefulness of Strain Echocardiography

Background: In patients with aortic stenosis, subtle alterations in myocardial mechanics can be detected by speckle-tracking echocardiography before reduction of left ventricular ejection fraction (LVEF).Methods: In this prospective study, 162 patients with aortic stenosis with an average aortic valve area of 0.7 +/- 0.2 cm(2) and a mean LVEF of 60 +/- 11% were included. Global longitudinal strain (GLS) and mechanical dispersion (SD of time from Q/R on the electrocardiogram to peak strain in 16 left ventricular segments) were assessed using echocardiography, and all-causemortality (n=37) was recordedduring37 +/- 13 months of follow-up.Results: Overall, nonsurvivors had more pronounced mechanical dispersion and worse GLS compared with survivors (74 +/- 24 vs 61 +/- 18 msec [PConclusion: Increased mechanical dispersion may be a risk marker providing novel prognostic information in patients with aortic stenosis.