BACKGROUND: Symptomatic @entity1 with severe @entity472 ( @entity472 ) demonstrate abnormal left ventricular (LV) mechanics. The aim of this study was to compare mechanics in asymptomatic and symptomatic @entity1 with severe @entity472 using two-dimensional myocardial strain imaging. METHODS: One hundred fifty-four @entity1 with severe @entity472 (aortic valve area  <= 1.0  cm(2)) referred to a heart valve clinic from 2004 to 2011 were studied. Thirty @entity1 were asymptomatic, with normal LV ejection fractions (>= 55%), without other significant @entity340 or @entity854 . Thirty-two symptomatic @entity1 who underwent early aortic valve replacement, with similar age, gender, LV ejection fraction, and aortic valve area, were selected for comparison. Both groups were also compared with 32 healthy subjects with similar age and gender distributions and normal echocardiographic results who served as controls. LV longitudinal and circumferential strain and rotation were measured using speckle-tracking software applied to archived echocardiographic studies. Conventional echocardiographic and myocardial mechanical parameters were compared among the study subgroups. RESULTS: @entity1 with asymptomatic severe @entity472 demonstrated smaller reductions in @entity6475 , higher (supernormal) apical circumferential strain (-38      6% vs -35      4%, P  <  .05), and extreme (supernormal) @entity717 (12.2      4.9   vs 2.9      1.7  , P  <  .0005) compared with symptomatic @entity1 . @entity717 < 6   was the single significant predictor of symptoms in logistic regression analysis of clinical, echocardiographic, and mechanical parameters. Twelve asymptomatic @entity1 underwent eventual aortic valve replacement and showed decreases in strain and @entity717 compared with baseline values. CONCLUSIONS: Longitudinal strain was uniformly low in @entity1 with severe @entity472 and lower in those with symptoms. Compensatory circumferential myocardial mechanics (increased apical circumferential strain and rotation) were absent in symptomatic @entity1 . Thus, myocardial mechanics may help in the follow-up of @entity1 with severe @entity472 and timing of valve surgery.

Symptoms in Severe XXXX are Associated with Decreased Compensatory Circumferential Myocardial Mechanics.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity340 :: ('MESH:D006349', 'Disease') :: ['valvular disease'] @entity6475 :: ('MESH:D013180', 'Disease') :: ['longitudinal strain'] @entity854 :: ('MESH:D018376', 'Disease') :: ['wall motion abnormalities'] @entity717 :: ('MESH:D009069', 'Disease') :: ['Apical rotation', 'apical rotation'] @entity472 :: ('MESH:D001024', 'Disease') :: ['AS', 'aortic stenosis']
@entity472 :: (MESH:D001024,Disease) :: ['Aortic Stenosis']
