Table 5 Studies evaluating the role of strain parameters in aortic regurgitation (in chronological order)

Marciniak et al. [93]

2009

N/A

59 patients with mild/moderate/severe AR and 22 healthy controls

Radial as well as longitudinal peak systolic strain rates were significantly decreased in patients with both moderate and severe AR compared with healthy subjects. Changes in regional LV deformation correlated inversely both with LV end-diastolic volume and with end-systolic volume

Olsen et al. [95]

2011

19 ± 8 months

64 patients with chronic severe AR

Reduced myocardial systolic strain, systolic strain rate and early diastolic strain rate by speckle-tracking echocardiography were associated with disease progression during conservative management and with impaired outcome after surgery. Conventional parameters of LV function and size (LVEF and LVEDDi) were associated with outcome after surgery but not with outcome during conservative management

Mizarienė et al. [104]

2012

N/A

26 patients with moderate AR, 34 patients with severe AR and 28 healthy controls

The LV GLS, radial strain, and LV systolic diameter were the independent predictors of LV ejection fraction in the patients with AR. LV long-axis dysfunction with an increased apical rotation was present in the patients with moderate AR, while LV radial function and systolic basal rotation were found to be reduced in more advanced disease

Ewe et al. [105]

2015

4.2 ± 3.2 years

129 patients with moderate-to-severe or severe AR and LVEF > 50%

In asymptomatic patients, impaired baseline LV GLS or circumferential strain was independently associated with the need for AVR

Lavine et al. [97]

2015

N/A

27 patients with no pathology, 87 patients with chronic AR and LVEF > 50%, 66 patients with chronic AR and LVEF < 50% and 82 patients with hypertensive heart disease

In chronic AR there is impaired longitudinal function despite preserved EF: GLS was reduced in all patients with AR compared to normal subjects, GLS was also reduced in patients with AR and LVEF > 50% compared to patients with hypertensive heart disease. GLS was well correlated with non-invasive estimated LV filling pressures and pulmonary systolic arterial pressures

Park et al. [94]

2015

5.3 years

60 patients with chronic severe AR (median follow up 64 months)

On multivariate analysis decreased LV global strain rate (measured on apical four chamber view) was proved to be an independent predictor of mortality in patients with chronic AR

Hulshof et al. [103]

2017

N/A

7 patients with severe AR, 10 patients with severe AS and 10 healthy controls

Distinct strain–volume loop characteristics were present in the 3 subgroups who showed comparable longitudinal peak strain. Early systolic strain and linear slope during systole (relationship between strain and volume) were lower in AR and AS patients compared with control subjects, with AR patients demonstrating lower values compared with AS

Verseckaite et al. [106]

2018

5 years

67 asymptomatic patients with chronic moderate or severe AR and LVEF > 50%

GLS was an independent predictor of LVEF deterioration. Probability of LVEF deterioration was significantly greater in patients with GLS

Alashi et al. [96]

2019

6.95 years

865 patients with severe AR and LVEF ≥ 50% who underwent AVR

Baseline LV-GLS value worse than -19% was associated with reduced survival. In a subgroup of patients who returned for 3- and 12-month follow-up examinations, persistently impaired LV-GLS was associated with increased mortality

Kalkan et al. [101]

2021

N/A

64 patients with mild, moderate and severe AR

This study showed that LA-Res and LA pump parameters of the patients with severe AR significantly decreased compared to those of the mild and moderate AR group

Jenner et al. [100]

2021

1 year

65 patients with severe AR who underwent AVR

Preoperative left atrial strain during the conduit phase added to LVESVi for the prediction of impaired LV functional and structural recovery after aortic valve replacement (accuracy 70%; addition of left atrial strain during the conduit phase to LVESVi p = 0.006)

Martín et al. [102]

2022

2.8 years

126 asymptomatic patients with chronic severe AR

LVEDV and E/e’ ratio were significant predictors of adverse events. Lower LA reservoir strain values (less than median of 34%) were associated with higher rates of events (hospital admission due to heart failure, cardiovascular mortality, or aortic valve surgery)