Evaluation of left ventricular myocardial function in patients with aortic stenosis by layer-specific strain / 中华超声影像学杂志

ABSTRACT

Objective To investigate the value of layer-specific strain in evaluating the changes of left ventricular three layers and segmental myocardial function in patients with different degree of aortic stenosis (AS).Methods Ninety-eight AS patients were selected as AS group from December 2017 to June 2019 in Henan Provincial People's Hospital,they were divided into mild AS group(30 cases),moderate AS group (33 cases),severe AS group(35 cases);30 healthy subjects were enrolled as control group.Longitudinal strain (LS),circumferential strain (CS) of endocardium,mid-myocardium,epicardium,global full thickness and each segment of left ventricular myocardium were measured by layer-specific strain and then compared.Results Compared with the control group,Vmax,PPG,interventricular septal thickness in diastole(IVSD),left ventricular posterior wall thickness in diastole(LVPWD),left ventricular mass index(LVMI),and E/e increased in all three AS groups(all P ＜0.05).There were stepwise decreases of global full-thickness LS,CS with the increases of AS degree(all P ＜0.05).LS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers in basal and middle left ventricular(LV) segments of different AS groups were decreased compared with the control group (all P ＜0.05).LS of three myocardium layers in apical LV segment were decreased in severe AS group compared with control group (all P ＜0.05).Compared with the mild AS group,the endocardial myocardium LS in moderate AS group decreased,and the difference was statistically significant (P ＜ 0.05),and LS and CS of mid-myocardial,epicardial myocardium decreased,but the difference was statistically insignificant (all P ＞ 0.05).There were no significant difference in CS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers in basal,middle and apical LV segments between mild AS group and control group (all P ＞ 0.05).CS of endocardial,mid-myocardial,epicardial and global full-thickness myocardium layers were decreased in moderate AS and severe AS groups compared with control group (all P ＜0.05).CS of endocardial,mid-myocardial myocardium layers in basal and middle LV segments were decreased in moderate AS group compared with control group(all P ＜0.05).CS of three myocardium layers in basal,middle and apical LV segments were decreased in severe AS group compared with control group (all P ＜ 0.05).Conclusions Layer-specific strain can quantitatively evaluate left ventricular three layers and segmental myocardial function in patients with aortic stenosis,and has certain clinical application value.