Left Ventricular Longitudinal Strain Assessment by Speckle Tracking Echocardiography in Patients with Chronic Aortic Regurgitation

Abstract Background: Chronic aortic regurgitation (AR) is associ-ated with subtle myocardial changes that will lead eventually lead to ventricular dysfunction. To establish a proper treatment plan, speckle tracking echocardiography (STE) has emerged as a sensitive tool to detect such changes compared to the limited conventional echocardiography. Aim of Study: This study was conducted to evaluate left ventricular performance in patients with chronic AR using 2- D STE. Patients and Methods: This prospective case control study included 30 cases diagnosed with moderate to severe AR along with 30 age and gender matched healthy controls. All patients were clinically assessed. Additionally, all subjected were assessed with conventional and 2-D STE. Global longi-tudinal strain was evaluated and recorded. Results: Both ejection fraction and fractional shortening showed a significant decrease in cases versus controls. On the other hand, aortic root diameter, left atrial dimensions, interventricular septal thickness in diastole, left ventricular internal dimensions during systole and diastole, together with interventricular septal thickness in systole showed a significant increase in cases compared to controls. Global longitudinal strain had mean values of –18.33±7.932 and –21.70±3.631 in cases and controls respectively, with a significant decrease in cases versus controls (p-value 0.030). Conclusion: Subtle or substantial reduction of LV systolic function was present in AR group as evidenced by a significant reduction of left ventricular global longitudinal strain. Hence, strain may act as a sensitive indicator for subclinical dysfunc-tion in such cases.