Abstract:Objective: The aim of the study was to assess the predictive value of global left atrial longitudinal strain (GLAS) for risk stratification in patients with asymptomatic severe aorta stenosis (AS) by two-dimensional speckle tracking imaging (2DSTI). Methods: A total of 85 severe AS patients with preserved left ventricular ejection fraction (LVEF≥50%) were included in our cohort, all patients were performed echocardiography and strain analyze to measure the conventional echocardiography parameters and GLAS. All patients were followed-up for one year, and the endpoints of follow-up were patients presented with heart failure: NYHA III-IV, NT-proBNP level greater than 450pg/mL (<45 years old), greater than 900pg/mL (50-75 years old), greater than 1800pg/mL (>75 years old), hospitalized due to heart failure, syncope, or death from cardiovascular events. Multivariate logistic regression analysis was used to analyze the correlation between clinical data, conventional echocardiographic parameters and GLAS, to explore the best predictors in the long-term follow-up. Result: After a year of follow-up, 34 patients (40%) reached one of the endpoints. Patients with events showed lower LVEF, aortic valve area, and GLAS than those maintenance asymptomatic group;However, the prevalence of diabetes and heart failure, E/e’ and LAVImax were significantly higher than those in the maintenance asymptomatic group. Multivariate regression analyze show that GLAS was the only independent predictors of adverse cardiovascular events in AS patients.Conclusion: 2DSTI can synthesize evaluate the changes of LA functions, and GLAS was the best indicator for predicting the risk stratification and prognosis in patients with asymptomatic severe AS. Impaired GLAS was associated with high risk of adverse cardiac events. This parameter may help to reduce the mortality of patients, and so improve the prognosis. [Keywords] Aortic stenosis; Speckle tracking imaging; Risk stratification;Left atrial