Left ventricular global longitudinal strain (GLS) measured by speckle tracking echocardiography in two asymptomatic patients with severe AS, a similar degree of concentric LVH and LVEF > 60%. Reduced values of longitudinal deformation in the basal LV segments are observed in the first patient, but with a GLS value within normal range (−20%) (A). Impaired GLS (−15%) was found in the second patient, with more severely reduced values of longitudinal deformation in the basal segments (B). Stress echocardiography was performed in both patients. The second patient experienced dyspnea at a low level of exercise while the first remained asymptomatic. Angiography in the second patient revealed no significant coronary lesions.