Background .– Patients with severe aortic stenosis have impaired systolic function, despite a normal LVEF. Global Longitudinal Strain (GLS) is a simple and reproducible measurement of these abnormalities of contraction. Measurements of distortion (strain) in the radial (GRS) and circumferential direction (GCS) are also possible.

Objective .– We want to evaluate the impact of aortic valve replacement for severe symptomatic aortic valve stenosis on the myocardial function recovery evaluated according to a dynamic protocol: at rest and during a standardized stress echocardiography.

Methods .– We prospectively studied 22 patients 6 months after aortic valve replacement. These patients were treated with the same aortic valve bioprosthesis (Magna Ease). These patients gave their informed consent. They were able to provide a standardized effort on a tilting table. Rest echocardiography showed normal functioning of the prosthesis, normal LVEF, without other valvular disease.

Results .– At rest, left ventricular ejection fraction(68.68 ± 9.16%), septal wall end-diastolic thickness (13.23 ± 2.68%), left ventricular end-diastolic diameter (50.4 ± 8.5 mm) were measured at the same time that the GLS (−17.27 ± 3.23%). Despite a normal LV EF, 36.36% of patients have a GLS < −17%. The GCS was on average −20.85 ± 5.16%. 22.7% of patients have a GCS < −17%. Nevertheless most patients have normal GRS (44.69 ± 18.02%). During exercise, most patients in our study do not increase LVEF, despite the good hemodynamic performance of the valve prosthesis (mean trans-aortic gradient at rest was 17.9 ± 7.52 mm Hg, with a mean valve area to 1.31 ± 0.29 cm ² at rest and 1.32 ± 0.27 cm ² during exercise). Only 31.8% of patients show an increase in LVEF greater than 5% during a planned submaximal effort at 60-watt. The patients should reach a heart rates ∼110 ± 10/min and exercise should last over 8 minutes. The GLS does not increase during exercise with a mean value to the effort of −18.05 ± 3.47%. Only 9% of patients show increase of LV longitudinal function during exercise with an increase in GLS of 5% or more.

Conclusion .– After aortic valve replacement for severe aortic stenosis, abnormal LV systolic function can be objectified via measurements of the GCS and GLS.