Relación entre el strain rate y la estructura miocárdica en la estenosis aórtica grave

Introduccion: En la estenosis aortica sintomatica grave (EASG), la alteracion del strain global longitudinal sistolico (SGLS) tendria correlacion con las modificaciones de la histoarquitectura y podria identificar compromiso contractil temprano en pacientes con fraccion de eyeccion conservada (FEyC). Objetivo: Analizar el SGLS, el volumen de colageno (VC), el area miocitaria (ArMi) y el compromiso contractil en pacientes con EASG y FEyC. Material y metodos: Se incorporaron 26 pacientes con EASG y FEyC (edad 67 ± 11 anos, 53% hombres). Se realizaron un estudio hemodinamico preoperatorio y una biopsia endomiocardica intraoperatoria para determinar el VC y el ArMi. Se identificaron tres grupos de pacientes: G1, hipertrofia ventricular izquierda (HVI) compensada sin enfermedad coronaria (n = 8); G2, HVI descompensada sin enfermedad coronaria (n = 7) y G3, HVI descompensada con enfermedad coronaria (n = 11). El SGLS se normalizo por volumen sistolico, estres meridional de fin de sistole (δ) y diametro de fin de diastole (DFD). Resultados: G1, G2 y G3, sin diferencias en volumen sistolico, δ y DFD y con diferencias en VC (%) (G1: 4,7 ± 1,2; G2: 8,4 ± 1,2; G3: 11,0 ± 3,0; p Background: In severe symptomatic aortic stenosis (SSAS) altered global longitudinal systolic strain (GLSS) would correlate with changes in myocardial histological architecture and could identify early contractile involvement in patients with preserved ejection fraction (PEF). Objective: The aim of this study was to analyze GLSS, collagen volume (CV), myocyte area (MyAr) and contractile involvement in patients with SSAS and PEF. Methods: Twenty six patients with SSAS and PEF (67±11 years old, 53% male) were included in the study. A preoperative hemodynamic study and an intraoperative endomyocardial biopsy were performed to determine CV and MyAr. Three groups of patients were identified: G1: compensated left ventricular hypertrophy (LVH) without coronary disease (n=8); G2: decompensated LVH without coronary disease (n=7) and G3: decompensated LVH with coronary disease (n=11). GLSS was normalized by stroke volume, meridional end-systolic wall stress (δ) and end-diastolic diameter (EDD). Results: No significant differences in stroke volume, δ and EDD were observed between groups G1, G2 and G3. Differences between groups were observed in: CV (%) (G1: 4.7 ± 1.2, G2: 8.4 ± 1.2, G3: 11.0 ± 3.0; p