Estenose aórtica e o Strain longitudinal

Global longitudinal strain is a strong independent predictor of all-cause mortality in patients with aortic stenosis

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Conclusions Global Longitudinal Strain (GLS) detects subclinical dysfunction and has incremental prognostic value over traditional risk markers including haemodynamic severity, symptom class, and LVEF in patients with AS. Incorporation of GLS into risk models may improve the identification of the optimal timing for AV replacement.
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GLS is predominantly governed by the sub-endocardial layer, therefore it is the most sensitive strain parameter in the presence of myocardial disease.13The middle and subepicardial myocardial layers are concerned with circumferential and twist mechanics and help determine LVEF, however are less susceptible to damage from chronic pressure overload in AS.
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Vejam como faz sentido o Strain longitudinal ser mais sensível às alterações da estenose aórtica o que o coloca como método de escolha na deformação e dano subclínico.
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