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Article

Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement

1
Division of General Cardiology, Department of Cardiac, Thoracic and Vascular Medicine, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy
2
Health Science Interdisciplinary Center, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy
3
Department of Experimental and Clinical Medicine, University of Florence, 50134 Florence, Italy
4
Division of Cardiac Surgery, Careggi University Hospital, 50134 Florence, Italy
*
Author to whom correspondence should be addressed.
Diagnostics 2024, 14(19), 2176; https://doi.org/10.3390/diagnostics14192176 (registering DOI)
Submission received: 29 August 2024 / Revised: 26 September 2024 / Accepted: 27 September 2024 / Published: 29 September 2024
(This article belongs to the Section Medical Imaging and Theranostics)

Abstract

Background and Objectives: In patients with severe aortic stenosis (AS), left ventricular systolic dysfunction is one of the main predictors of adverse events after surgical aortic valve replacement (SAVR). However, more patients undergo surgery earlier, often with preserved systolic function. In these cases, global longitudinal strain (GLS) has been proposed as a marker of ventricular remodeling post-surgery. This study aims to evaluate GLS variation in patients undergoing SAVR and explore differences across the diastolic dysfunction classes. Methods: From June 2020 to March 2023, patients with AS and preserved ejection fraction (EF) requiring SAVR were enrolled. Echocardiographic evaluations were conducted preoperatively, seven days post-surgery, and twelve months after surgery. Patients were divided into two groups based on the severity of diastolic dysfunction: Group A (grade I) and Group B (grades II–III). Results: The final analysis included 108 patients (mean age 71.3 ± 7.2 years). Twenty-two patients (20.4%) also underwent coronary artery bypass grafting (CABG). The preoperative EF averaged 61.6 ± 6.03%, with no significant differences between groups. Preoperative GLS was 16 ± 4.3%, decreasing to 12.8 ± 3.4% postoperatively (p < 0.0001). GLS was comparable between the groups preoperatively (p = 0.185) and postoperatively (0.854). After twelve months, GLS improved in both groups (Group A: 17.7 ± 3.4%, Group B: 15.7 ± 3.2%, p < 0.0001), but only Group A showed significant improvement from preoperative values (p = 0.018). SAVR improved GLS regardless of CABG intervention. Conclusions: SAVR in patients with preserved LVEF results in an early reduction in GLS, regardless of diastolic dysfunction. After twelve months, GLS improved significantly, with significant recovery only in patients with mild dysfunction.
Keywords: global longitudinal strain; aortic stenosis; cardiac surgery global longitudinal strain; aortic stenosis; cardiac surgery

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MDPI and ACS Style

Bonanni, F.; Caciolli, S.; Berteotti, M.; Grasso Granchietti, A.; Tozzetti, V.; Cenni, N.; Servoli, C.; Bandini, M.; Marchi, E.; Del Pace, S.; et al. Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement. Diagnostics 2024, 14, 2176. https://doi.org/10.3390/diagnostics14192176

AMA Style

Bonanni F, Caciolli S, Berteotti M, Grasso Granchietti A, Tozzetti V, Cenni N, Servoli C, Bandini M, Marchi E, Del Pace S, et al. Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement. Diagnostics. 2024; 14(19):2176. https://doi.org/10.3390/diagnostics14192176

Chicago/Turabian Style

Bonanni, Francesca, Sabina Caciolli, Martina Berteotti, Andrea Grasso Granchietti, Valentina Tozzetti, Noemi Cenni, Chiara Servoli, Marta Bandini, Enrico Marchi, Stefano Del Pace, and et al. 2024. "Left Ventricular Diastolic Dysfunction Predicts Global Longitudinal Strain Recovery after Surgical Aortic Valve Replacement" Diagnostics 14, no. 19: 2176. https://doi.org/10.3390/diagnostics14192176

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