{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T12:12:43Z","timestamp":1780402363719,"version":"3.54.1"},"reference-count":40,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,5,27]],"date-time":"2018-05-27T00:00:00Z","timestamp":1527379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2018,9]]},"abstract":"Background<\/jats:title>The management of asymptomatic patients with aortic regurgitation (AR<\/jats:styled-content>) and preserved left ventricular (LV<\/jats:styled-content>) ejection fraction (LVEF<\/jats:styled-content>) remains challenging. The purpose of the study was to assess the early changes of LV<\/jats:styled-content> mechanics by 2D speckle\u2010tracking echocardiography (2D\u2010STE<\/jats:styled-content>) in order to predict a decrease in LVEF<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>Sixty\u2010seven patients (age, 47\u00a0\u00b1\u00a015\u00a0years) with asymptomatic moderate (n\u00a0=\u00a027) and severe AR<\/jats:styled-content> (n\u00a0=\u00a040) with preserved LVEF<\/jats:styled-content> were prospectively followed for about 5\u00a0years. Sixty healthy age\u2010matched controls were included in the study. Standard echocardiography and 2D\u2010STE<\/jats:styled-content> were performed at the baseline and follow\u2010up. The primary endpoint was a deterioration of the LVEF<\/jats:styled-content> (\u226450%).<\/jats:p><\/jats:sec>Results<\/jats:title>At baseline, global LV<\/jats:styled-content> longitudinal peak systolic strain (GLS<\/jats:styled-content>) and strain rate (GLSR<\/jats:styled-content>s) were decreased in patients with severe AR<\/jats:styled-content> compared to controls (\u221218.9\u00a0\u00b1\u00a02.4 vs 20.0\u00a0\u00b1\u00a02.1%; \u22121.05\u00a0\u00b1\u00a00.19 vs \u22121.18\u00a0\u00b1\u00a00.15 1\/s, P<\/jats:italic>\u00a0<\u00a0.05, respectively). In the moderate AR<\/jats:styled-content> group, GLS<\/jats:styled-content> was not different from that of the control group, but GLSR<\/jats:styled-content>s was significantly lower than in controls. The primary endpoint was reached in 12 patients with severe AR<\/jats:styled-content>, while this was not observed in patients with moderate AR<\/jats:styled-content>. In multivariate analysis, GLS<\/jats:styled-content> was an independent predictor of LVEF<\/jats:styled-content>. According to ROC<\/jats:styled-content> curve analysis, probability of primary endpoint occurrence was significantly greater in patients with GLS<\/jats:styled-content> values \u2265\u221218.5% (AUC<\/jats:styled-content>: 0.89, P<\/jats:italic>\u00a0<\u00a0.01).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>The reduction of LV<\/jats:styled-content> longitudinal deformation is a sign of early subclinical LV<\/jats:styled-content> dysfunction. GLS<\/jats:styled-content> is a prognostic predictor of LV<\/jats:styled-content> dysfunction and may be potentially useful for optimal timing of surgery for patients with significant AR<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14030","type":"journal-article","created":{"date-parts":[[2018,5,27]],"date-time":"2018-05-27T10:14:16Z","timestamp":1527416056000},"page":"1277-1288","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The predictive value of left ventricular myocardium mechanics evaluation in asymptomatic patients with aortic regurgitation and preserved left ventricular ejection fraction. 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