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Background: It is not well known about the implication of left ventricular (LV) strain as a predictor for mortality in patientswith chronic aortic regurgitation (AR). The purpose of this study was to investigate whether global longitudinal strain measuredby two-dimensional speckle-tracking echocardiography could predict long-term outcome in patients with chronic AR. Methods: This is a single center non-randomized retrospective observational study. The patients with chronic AR from January2002 to December 2012 were retrospectively enrolled. Following patients were excluded; combined other significant valvulardisease, previous heart surgery, aortic disease, congenital heart disease, acute AR and young age under 18 years old. Finally, 60patients were analyzed and the LV global strain rate was measured on apical four chamber image (GS-4CH). Results: During 64 months follow-up duration, 16 patients (26.7%) were deceased and 38 patients (63.3%) underwent aorticvalve replacement (AVR). Deceased group was older (69 years old vs. 51 years old, p < 0.001) and had lower longitudinal strain(-12.05 ± 3.72% vs. -15.66 ± 4.35%, p = 0.005). Kaplan-Meier survival curve stratified by GS-4CH showed a trend of differentevent rate (log rank p = 0.001). On multivariate analysis by cox proportional hazard model adjusting for age, sex, body surfacearea, history of atrial fibrillation, blood urea nitrogen, LV dilatation, LV ejection fraction and AVR, decreased GS-4CH provedto be an independent predictor of mortality in patients with chronic AR (hazard ratio 1.313, 95% confidence interval 1.010–1.706, p = 0.042). Conclusion: GS-4CH may be a useful predictor of mortality in patient with chronic AR.

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