The signifi cance of global longitudinal strain of left ventricular in the classifi cation of stages of aortic stenosis based on the extravalvular cardiac damage

Abstract

Severe aortic stenosis (AS) is characterized not only by degenerative changes in the aortic valve but also by extravalvular cardiac damage. Recently, a new staging classifi cation of AS has been proposed based on the extent of cardiac damage, as well as its modifi ed variants with the addition of a measure of global longitudinal strain of the left ventricular (GLS LV), as an earlier predictor of preclinical LV systolic dysfunction.Aim. To evaluate the signifi cance of GLS LV in the staging classifi cation of AS based on the extent of cardiac damage according to a multidisciplinary hospital.Мaterials and methods. 66 patients with severe AS with available GLS LV by speckle tracking echocardiography were selected and analyzed retrospectively.Results. Patients were categorized according to cardiac damage on ECHO: stage 0 was determined in 2 (3%) patients; stage 1 — 10 (15%), stage 2 — 41 (62%), stage 3 — 13 (20%). The use of staging classifi cation of AS with addition of GLS LV quintiles led to patient reclassifi cation. Thus, stage 4 included patients from stage 2 and stage 3 cardiac damage.Conclusions. In patients with severe AS, the adding the GLS LV to the routine ECHO can help to more accurately determine the stages of AS and make the right decision on the management tactics of such patients.