AUTHOR=Chen Jianxiong , Yang Xiaohuan , Li Xinyi , Jin Lin , Wu Lingheng , Zhang Mengjiao , Du Lianfang , Luo Xianghong , Li Zhaojun 

TITLE=Association between myocardial layer-specific strain and high 10-year risk of atherosclerotic cardiovascular disease in hypertension—findings from the China-PAR project study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1460826

DOI=10.3389/fcvm.2024.1460826

ISSN=2297-055X

ABSTRACT=Objectives: Myocardial layer-specific strain is a sensitive tool for detecting myocardial dysfunction. The objective of this study was to assess the left ventricle (LV) functional change using myocardial layer-specific strain and its relationship to 10-year atherosclerotic cardiovascular disease risk (10Y-ASCVDR) in individuals with hypertension (HP). 
Methods: The parameters of left ventricle (LV) structure, layer-specific global longitudinal strain (GLSww, GLSendo, GLSmid, GLSepi), and layer-specific global circumferential strain (GCSww, GCSendo, GCSmid, GCSepi) were analyzed by two-dimensional speckle tracking echocardiography in 239 hypertensive patients and 124 control group subjects. Furthermore, according to the 10Y-ASCVDR scores, the participants were divided into low-risk (LR) and high-risk (HR) subgroups. The correlation between myocardial layer-specific strain and 10Y-ASCVDR was further analyzed by the restricted cubic spline function (RCS).
Results: The values of GLSww, GLSepi, GLSmid, and GLSendo were significantly lower in HP patients with HR than in HP patients with LR and controls (p <0.05). However, there were no significant differences in layer-specific GCS between the groups (p >0.05). RCS analysis showed that 10Y-ASCVDR exhibited a significant J-shaped relationship with layer-specific GLS and GCS. After adjusting for confounding factors, GLSww (β = 0.156, p = 0.042), GLSmid (β = 0.161, p = 0.032), GCSendo (β = 0.163, p = 0.024) and GCSmid (β = -0.175, p = 0.030) were identified as independent influencing factors for high 10Y-ASCVDR.
Conclusions: In hypertensive patients, myocardial layer-specific strain, especially GLS, sensitively detected LV dysfunction and showed a significant J-shaped relationship with 10Y-ASCVDR. GCSmid may have a compensatory effect on myocardial impairment.
LV myocardial layer-specific strain may help to understand the early compensatory mechanisms of myocardium in hypertension.