Imaging Aortic Regurgitation: The Incremental Benefit of Speckle Tracking Echocardiography



Pankaj Garg1, 2, *, Firas Yassin1, Roman Leischik3
1 Cardiothoracic Unit, Chesterman Wing, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
2 Multidisciplinary Cardiovascular Research Centre & Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
3 Witten/Herdecke University, Faculty of Health, School of Medicine, Cardiology, Hagen, Germany


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© Garg et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/bync/ 4.0/), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Cardiology and Cardio-thoracic Surgery, Chesterman Wing, Northern General Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, UK; Tel: +44-114-226-6115; Fax: +44-114-261-0350; E-mail: Pankaj.Garg@sth.nhs.uk


Abstract

Aortic regurgitation (AR) affects global left ventricular mechanics. However, limited literature is available on how it may affect regional longitudinal strain.

We present a case where severe AR jet is thrashing the anterior-septal wall and reducing its overall longitudinal performance most likely secondary to increased wall shear stress in diastole. This new insight into patho-physiological process using deformation study may have supplementary impact in decision making for surgical intervention. Transthoracic echocardiography is the primary imaging modality for the assessment of AR as it offers evaluation of severity of AR, aetiology of AR, left ventricular (LV) dilatation, LV systolic function, left ventricular mass, diastolic function and global strain. This case highlights the regional disturbances in longitudinal strain in eccentric AR.

Keywords: Aortic regurgitation, cardiac mechanics, ejection fraction, strain, ultrasound imaging.