Valvular & structural heart disease
Impact of diastolic left ventricular strain rate on assessment of aortic regurgitation severity and timing of surgical intervention in patients with preserved left ventricular ejection fraction
Authors' conclusion
SRmin, which reflects LV load by AR, can assess AR severity and indicate the timing of therapeutic intervention in patients with preserved LVEF.
Study context
- Population
- Patients with chronic aortic regurgitation (AR) and left ventricular (LV) ejection fraction (LV ejection fraction (LVEF)) > 50%mean age, 73 years, 44% females, 17% moderate and 9% severe AR
- Participants
- 248 patients
- Exposure
- Mid-diastolic LV strain rate against conventional AR measures
- Outcome
- Correlation of SRmin with vena contracta width
Main finding
As reported in the abstract
- R
- 0.40
- P
- P < 0.001
Observational data: associations, not effects.
Further findings
Time to surgery in 63 patients with moderate or severe AR · time to surgery shorter in SRmin ≥ 0.085 group
P = 0.034
Correlation of SRmin with regurgitant volume
- R
- 0.59
- P
- P < 0.001
Diagnostic performance of SRmin cutoff of 0.085 (1/s) for severe AR
- Sensitivity and specificity
- 87%
- Area under the curve
- 0.943
Reproducibility of SRmin
- Intraclass correlation coefficient, intra- and inter-observer
- 0.97
- Bland-Altman mean (standard deviation) bias, intra-observer
- 0.004 (0.027)
- Bland-Altman mean (standard deviation) bias, inter-observer
- 0.002 (0.026)
- Mean frame rate of 67 Hz (61-71)
Original publication
Impact of diastolic left ventricular strain rate on assessment of aortic regurgitation severity and timing of surgical intervention in patients with preserved left ventricular ejection fraction. Eur Heart J Cardiovasc Imaging. Published 26 July 2025. doi:10.
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