Electrocardiographic Strain Sign as a Symptom Equivalent for the Severity of Aortic Stenosis

Abstract

Objectives: Aortic stenosis is a disorder characterized by inflammation, atherosclerosis, and calcium deposition in theaortic valve. The asymptomatic patients with severe aortic stenosis with normal left ventricular function (C1 stage)have been recommended clinical monitoring according to American guidelines. However, symptom definition by thepatients may be challenging. Besides, the symptom-dependent decision for the selection of the therapy can be latefor valve intervention. In this study, we evaluated the use of electrocardiographic strain sign as equivalent of aorticstenosis symptoms.Methods: In this retrospective study, 102 consecutive patients with AS were examined between October 2014 to September2019. According to electrocardiographic strain sign, the patients were divided into group I (strain sign exist)and group II (without strain sign). These groups were studied in terms of trans-aortic gradient and symptoms (angina,syncope, and dyspnea).Results: The relationship between strain availability and higher gradient was found statistically important. Strain signsensitivity and specificity in prediction ≥80 mmHg gradient had 76.3% and 83.3%, respectively. The relationship betweenstrain and symptoms availability was found statistically important (p