**16.3 Multi-layer strain**

• Left ventricular myocardial strain gradient using a novel multi-layer transthoracic echocardiography technique positively correlates with severity of aortic stenosis [23].

**55**

**Author details**

United States

Ernesto E. Salcedo1,2\* and Edward A. Gill1,2,3

provided the original work is properly cited.

important group of patients with aortic valve disease.

2 University of Colorado Hospital, Aurora CO, United States

\*Address all correspondence to: ernesto.e.salcedo@ucdenver.edu

Medical Campus, United States

1 Division of Cardiology, University of Colorado School of Medicine, Anschutz

3 Interventional Echocardiography, University of Colorado Hospital, Aurora, CO,

© 2020 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

*Clinical Applications of Strain Imaging in Aortic Valve Disease*

• Early diastolic strain rate in relation to systolic and diastolic function and

• Preoperative left atrial strain predicts postoperative atrial fibrillation in patients undergoing aortic valve replacement for aortic stenosis [40].

Deformation imaging, particularly in the form of global longitudinal strain, has evolved as a powerful tool in the evaluation of ventricular function in patients with aortic valve disease. GLS is particularly suited to detect subclinical LV dysfunction, before a drop in LV ejection fraction, providing the opportunity to intervene earlier to prevent serious and permanent LV dysfunction. The role of GLS in the management of aortic stenosis is quite robust, illuminating nuances of LV dysfunction in aortic valve disease such as impact in severity of AS, prognosis, timing for surgery and interventions, low gradient aortic stenosis and presence of associated coronary artery disease, among others. Similar added value has been demonstrated in the application of GLS in the detection of subclinical LV dysfunction in patients with aortic regurgitation. Very little information exists in the use of GLS in patients with mixed aortic valve disease providing an opportunity for future research in this

*DOI: http://dx.doi.org/10.5772/intechopen.93341*

prognosis in aortic stenosis [52].

**16.4 Diastolic strain**

**16.5 Left atrial strain**

**17. Conclusions**
