LA Strain & valvular heart disease
LASr <17,4% as a marker for the development of AFIB in symptom-free mitral stenosis patients (4a follow-up)
LASr post Stress in MR >16% = 3a event free survival likely
Post-OR biological AV LASr <16,9% sensitivity 86%, specificity 91% for new onset AFIB
Valvular heart disease
Aortic stenosis
Partly fibrotic changes (GLS -21 to -15%); diffuse „replacement“ fibrosis (cut-off -16,2%) — LV & LA stiffness & diastolic dysfunction increase
EF (acute) & GLS (acute and gradually) improve — GLS is a good follow-up parameter after TAVR
Apical to basal Strain ratio >1,9 as a marker for PM dependency (post-TAVR)
Aortic valve regurgitation
Pre-operatively GLS >-19,5% — worse prognosis; asymptomatic AR GLS >-19,5% — mortality is increased
Mitral valve regurgitation
GLS >-21% pre operatively ➜ worse outcome in primary MR (GLS + STS score)
GLS >-20,7% + elevated BNP ➜ worse outcome in primary MR (10a follow-up)
GLS >-21,7% — primary MR with normal EF (>60%) & normal LV-dimensions ➜ worse outcome
GLS >-18,1% pre operatively ➜ LV dysfunktion after valve surgery will persist
MitraClip: STS-score + GLS cut-off -14,5% for worse outcome (1a follow-up)
CAVE: for healthy individuals, the GLS in MR is already significantly pathological
Secondary MR — LASr significantly reduced in relevant MR (<10%) with worse prognosis
Tricuspid valve regurgitation
A reduction in FWS >-23% is associated with a worse outcome in severe (or more) TR
A reduced RASr in severe TR is a predictor for mortality and heart failure — cut-off 9,4%
