Department of Cardiac and Vascular Diseases, Jagiellonian University Medical College, John Paul II Hospital, Cracow, Poland.
Med Sci Monit. 2012 Dec;18(12):MT91-6. doi: 10.12659/msm.883587.
Global longitudinal peak strain (GLPS) quantifies left ventricle (LV) long-axis contractility. Early detection of LV systolic dysfunction is pivotal in diagnosis and treatment of patients with aortic stenosis (AS). This study was performed to assess LV longitudinal systolic function by GLPS derived from 2-dimensional speckle tracking imaging (2D-STI) in AS patients in comparison to standard echocardiographic parameters.
MATERIAL/METHODS: Laboratory tests, standard echocardiography, tissue Doppler imaging (TDI) and 2D-STI examinations with GLPS calculation were performed in 49 consecutive patients with moderate to severe AS with LV ejection fraction ≥50% and 18 controls.
While LVEF do not differentiate AS patients from controls, GLPS was significantly decreased in the AS group (-15.30 ± 3.25% vs. -19.60 ± 2.46% in controls, p<0.001). GLPS was significantly reduced in symptomatic AS patients as compared to the asymptomatic AS group [-15.5 (11.8-16.8) vs. -17.5 (14.7-18.9)%, p=0.02].
In aortic stenosis patients, despite normal left ventricle ejection fraction, long-axis left ventricular function is impaired, which manifests in global longitudinal peak strain reduction. GLPS reveals that LV function impairment is more pronounced in symptomatic as compared to asymptomatic AS patients. Further studies are needed to determine the prognostic significance of early LV function impairment in aortic stenosis patients showed by GLPS.
整体纵向峰值应变（GLPS）定量评估左心室（LV）长轴收缩功能。早期检测 LV 收缩功能障碍对于主动脉瓣狭窄（AS）患者的诊断和治疗至关重要。本研究旨在通过二维斑点追踪成像（2D-STI）获得的 GLPS 评估 AS 患者的 LV 纵向收缩功能，并与标准超声心动图参数进行比较。
材料/方法：对 49 例射血分数≥50%的中重度 AS 患者和 18 例对照者进行实验室检查、标准超声心动图、组织多普勒成像（TDI）和 2D-STI 检查，并计算 GLPS。
LVEF 不能区分 AS 患者和对照组，但 AS 组的 GLPS 明显降低（-15.30±3.25%比对照组-19.60±2.46%，p<0.001）。与无症状 AS 组相比，有症状 AS 患者的 GLPS 明显降低[-15.5（11.8-16.8）比-17.5（14.7-18.9）%，p=0.02]。
在主动脉瓣狭窄患者中，尽管左心室射血分数正常，但左心室长轴功能受损，表现为整体纵向峰值应变降低。GLPS 显示，与无症状 AS 患者相比，有症状 AS 患者的 LV 功能障碍更为明显。需要进一步研究来确定 GLPS 显示的主动脉瓣狭窄患者早期 LV 功能障碍的预后意义。
