BackgroundThemyocytedysfunctionmaybepresentinaorticstenosis(AS)patientswithpreservedleftventricularejectionfraction(LVEF).Earlyaorticvalvereplacement(AVR)canreversetheLVhypertrophyandimproveLVsystolicperformanceandclinicaloutcome.StrainimaginghasdemonstratedtobethemostappropriatemethodtoevaluateLVmyocardialcontractility.However,4D-strainimagingechocardiographyforthedetectionofsubclinicalleftventriculardysfunctioninASpatientswithpreservedLVEFisseldomstudied.MethodsWeprospectivelyenrolled30consecutivemoderatetosevereASpatientswithpreservedLVEF,and30healthycontrols.Conventionalechocardiographyand4D-strainimagingechocardiographywereundergoneintwogroups.The4Dstrainechocardiographicanalyseswereundertakenbyusing4DAutoLVQsoftware.ResultsComparedwiththehealthycontrols,themoderatetosevereASpatientswithpreservedLVEFhadsignificantlydecreasedglobalradialstrain(GRS),globallongitudinalstrain(GLS),globalareastrain(GAS)and4Dstrain(P<0.05),hadsignificantlyincreasedleftventricularend-diastolicvolumeindex(LVEDVI)andleftventricularmassindex(LVMI)(P<0.05),andhadlowerglobalcircumferentialstrain(GCS)(P>0.05).ConclusionsImpairedLVmyocardialcontractilityexistsinmoderatetosevereASpatients,althoughLVEFispreserved.4D-strainimagingechocardiographycandetectearlyleftventriculardysfunctioninASpatientswithpreservedLVEF.
