Value of Three-Dimensional Speckle-Tracking in Detecting Left Ventricular Dysfunction in Patients with Aortic Valvular Diseases

Background: The aim of this study was to investigate the value of three-dimensional speckle-tracking echocardiography for the detection of subclinical left ventricular dysfunction in patients with aortic valvular disease (AVD). Methods: Fifty-nine patients with AVD in New York Heart Association functional class I or II as well as 48 controls were recruited. Patients with AVD were divided further into those with aortic stenosis (AS; n = 34) and those with aortic regurgitation (AR; n = 25). All patients underwent conventional echocardiography and three-dimensional speckle-tracking echocardiography. Results: Analysis of variance showed global longitudinal strain to be compromised in the AR group (-16.9% vs -19.3%, P =.015) and more dramatically decreased in the AS group (-14.3% vs -19.3%, P <.001) compared with healthy controls. Impairment of global circumferential strain was observed in patients with AR (-15.9% vs -18.5%, P =.009) but not in those with AS (-18.2% vs -18.5%, P =.768). Global area strain and global radial strain were decreased in patients with AS and those with AR compared with controls, but the difference between the two subgroups was not significant. Conclusions: Strains measured by three-dimensional speckle-tracking echocardiography are useful indices of early-stage heart dysfunction caused by AVD. Longitudinal strain is more vulnerable to pressure overload caused by AS, whereas circumferential strain is more sensitive to volume overload due to AR.