Components of Left Ventricular Ejection and Filling in Patients With Aortic Regurgitation Assessed by Speckle-Tracking Echocardiography

The aim of our study was to evaluate left ventricular (LV) longitudinal, radial, and rotational function and its relationship with conventional LV parameters of systolic and diastolic function in patients with aortic regurgitation (AR) by speckle-tracking echocardiography.
Material and Methods. A total of 26 asymptomatic patients with moderate AR, 34 patients with severe AR, and 28 healthy controls were included into the study. LV rotation and longitudinal and radial strain were measured offline using speckle-tracking imaging.
Results. The systolic longitudinal strain (–18.3% [SD, 2.18%] vs. –21.0% [SD, 2.52%], P<0.05) and strain rate (–1.08 s^–1 [SD, 0.13 s^–1] vs. –1.27 s^–1 [SD, 0.15 s^–1], P<0.05) were significantly lower and apical rotation (11.3° [SD, 4.99°] vs. 8.30° [SD, 4.34°], P<0.05) as well as rotation rate (82.72°/s [SD, 28.24 °/s] vs. 71.00°/s [SD, 28.04 °/s], P<0.05) were significantly higher in the patients with moderate AR compared with the control patients. The LV systolic basal rotation, systolic radial strain, and diastolic radial strain rate were significantly reduced in the patients with severe AR compared with the control patients. The global longitudinal, radial strain, and LV systolic diameter were the independent predictors of LV ejection fraction in the patients with AR (R2=0.77). The LV systolic basal rotation in the control patients, diastolic longitudinal strain rate and systolic longitudinal strain in the patients with moderate and severe AR, respectively, were independent predictors of LV diastolic filling.
Conclusions. LV long-axis dysfunction with an increased apical rotation was present in the patients with moderate AR, while LV radial function and systolic basal rotation were found to be reduced in more advanced disease. LV diastolic filling depended on diastolic and systolic LV strain and rotation components in the patients with AR.