Cor Vasa . X:X

Purpose: The aim of the study was to explore the association between aortic valve (AV) degeneration and left ventricular (LV) functions and its relation with biomarkers.

Methods: 42 consecutive patients with degenerative AV disease and 25 controls were included. Degenerative AV were divided into stenotic and sclerotic valves. All patients underwent a two-dimensional (2D) transthoracic echocardiography and 2D speckle tracking echocardiography (STE) before and after semi-supine bicycle exercise test. We also evaluated the association between aortic sclerosis and biomarkers such as Galactine-3, high-sensitive (hs) troponin-T, C-reactive protein (CRP) and pro-BNP.

Results: LV global longitudinal strain (GLS) was significantly impaired in degenerative AV patients than control at peak exercise and recovery period. Left atrial reservoir and conduit functions were also significantly impaired in degenerative AV patients than control at basal, peak exercise, and recovery period. CRP, hs-troponin T, and pro-BNP were significantly higher in degenerative valve groups than controls. LV-GLS was inversely correlated with CRP levels, E/e’ at peak exercise, mean transvalvular aortic pressure gradients at rest and peak exercise. Multivariate linear regression analysis revealed that CRP levels and mean transvalvular aortic pressure gradients at peak exercise were independent predictors of LV-GLS at peak exercise.

Conclusions: Despite normal LV function, LV-GLS is not only significantly impaired in patients with aortic sclerosis but also the impairment is more pronounced during peak exercise. Results of the present study suggest that STE is a reliable tool in early detection on LV impairment in patients with aortic sclerosis.