Background: Despite left ventricle [LV] dysfunction, the aortic valve replacement risk for aortic stenosis [AS] was acceptable and related mainly to coronary artery disease and mean aortic gradient. The long-term survival was related to cardiac output and coronary disease.
The Aim of the work: To assess the potential role of three-dimensional [3D] speckle tracking echocardiography [STE] in the detection of systolic dysfunction of the LV in severe aortic stenosis pre- and post- valve replacement.  
Patients and Methods: Forty patients with severe AS in the pre- and post-surgical valve replacement were enrolled and assigned as group A. Group [B] included [20] sex-and age-matched apparently healthy individuals as a control group.
Results: There was a statistically significant differences between groups on the 2D and 3D STE but the 2D STE was the most significant as regard the global longitudinal strain. After aortic valve replacement, basic echocardiographic parameters showed no significant differences after than before aortic valve replacement. However, there was a significant improvement of global longitudinal strain and global circumferential strain after than before surgery by 2D and 3D speckle tracking echocardiography.
Conclusion: The speckle tracking echocardiography 2D or 3D is an optional significant modality for detection of subclinical left ventricular dysfunction in patients with severe aortic stenosis and preserved EF.