Myocardial systolic longitudinal function has been known to decrease in patients with severe aortic stenosis (AS). Preoperative peak systolic myocardial velocity at the septal mitral valve annulus (S’), measured using Doppler tissue imaging, was used as an indicator for myocardial systolic longitudinal function. The prognostic value and natural course of S’ after surgical aortic valve replacement for severe AS have not been elucidated. This retrospective observational study included patients from January 2006 to December 2018. The patients were divided to 2 groups (pre-S’_HIGH vs. pre-S’_LOW) with a cut-off 5.4 cm/s of preoperative S’ (pre-S’) that was identified by restricted cubic spline curve. The primary outcome was postoperative long-term all-cause mortality. Nine hundred and five patients were analyzed. All-cause mortality rate at the median follow-up period of 5.2 years was 12% in pre-S’_LOW and 8% in pre-S’_HIGH. Multivariate analysis showed that pre-S’_LOW was associated with an increased all-cause mortality (hazard ratio, 1.60; 95% confidence interval, 1.04–2.48; P = 0.032). Significantly different trajectories of postoperative S’ (post-S’) were found between two groups (P < 0.001 for difference): In pre-S’_LOW, post-S’ increased within 6 months after surgery, and gradually decreased over time, whereas it slowly decreased up to 5 years after surgery and then reached a plateau in pre-S’_HIGH. The difference in pre-S’ level maintained over time, and remained consistent in the adjusted analysis. Pre-S’ < 5.4 cm/s was found to be associated with an increased long-term all-cause mortality. In addition, the trajectories for post-S’ were different according to pre-S’, which remained after adjustment.

已知心肌收缩纵向功能在严重主动脉瓣狭窄 (AS) 患者中会降低。使用多普勒组织成像测量的间隔二尖瓣环 (S') 处的术前收缩期心肌峰值速度被用作心肌收缩纵向功能的指标。严重 AS 手术主动脉瓣置换术后 S' 的预后价值和自然病程尚未阐明。这项回顾性观察研究纳入了 2006 年 1 月至 2018 年 12 月的患者。患者被分为 2 组（pre-S' _HIGH与 pre-S' _LOW) 以 5.4 cm/s 的术前 S' (pre-S') 为截止值，由受限三次样条曲线确定。主要结果是术后长期全因死亡率。对 905 名患者进行了分析。在 5.2 年的中位随访期内，全因死亡率在 pre-S' _LOW中为 12% ，在 pre-S' _HIGH中为 8% 。多变量分析表明，S 前的_低水平与全因死亡率增加相关（风险比，1.60；95% 置信区间，1.04–2.48；P  = 0.032）。两组之间发现术后 S'（post-S'）轨迹存在显着差异（差异P  < 0.001）：在 pre-S' _LOW, post-S' 在手术后 6 个月内增加，并随时间逐渐下降，而它在手术后 5 年内缓慢下降，然后在 pre-S' _{HIGH 时达到稳定水平。}随着时间的推移，前 S 水平的差异保持不变，并在调整后的分析中保持一致。Pre-S' < 5.4 cm/s 被发现与长期全因死亡率增加有关。此外，post-S' 的轨迹根据 pre-S' 不同，调整后仍然存在。