2017 Volume 66 Issue 3 Pages 196-202
Background—Aortic valve stenosis (AS) is characterized by a progressive narrowing of the aortic valve. Consequently, in response to the increased afterload, the left ventricle becomes hypertrophic and demonstrates T wave abnormalities in electrocardiography (ECG). We investigated the relationship between the severity of AS and the strain T wave in ECG. Methods and Results—143 patients with moderate to severe AS (mean age, 77.6 ± 8.7 years; number of females 92; mean aortic valve area, 1.07 ± 0.27 cm2) underwent echocardiography and ECG. Patients with the strain T wave (n = 36) showed higher scores for left ventricular hypertrophy (n = 107) (p < 0.001), larger left atrial dimensions (p = 0.001), and more severe left ventricular diastolic dysfunction (p < 0.001) than those without strain T wave. Patients with the strain T wave had a smaller aortic valve area than patients without the strain T wave (p < 0.001). Receiver operating characteristic curve analysis showed that the aortic valve area was 0.94 cm2 and the aortic valve area index was 0.57 cm2/m2 in the patients with the strain T wave. The incidence of the strain T wave was higher in patients with aortic valve replacement than in those without aortic valve replacement (52.6% vs 21.0%, p = 0.008). Conclusion—Results suggest that the strain T wave in ECG is a useful marker of cardiac function and severity of aortic valve stenosis in patients with aortic valve stenosis.
