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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1460826

Association Between Myocardial Layer-Specific Strain and High 10-Year Atherosclerotic Cardiovascular Disease Risk in Hypertension -Findings from the China-PAR Project Study

Provisionally accepted
Jianxiong Chen Jianxiong Chen 1*Xiaohuan Yang Xiaohuan Yang 2*Xinyi Li Xinyi Li 3*Lin Jin Lin Jin 4Lingheng Wu Lingheng Wu 1*Mengjiao Zhang Mengjiao Zhang 5*Lianfang Du Lianfang Du 6*Xianghong Luo Xianghong Luo 7*Zhaojun Li Zhaojun Li 8,9*
  • 1 Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
  • 2 Department of Ultrasound, Shanghai Fourth People's Hospital, Shanghai,, China
  • 3 Business School, Hubei University, Wuhan, Hebei Province, China
  • 4 Department of Ultrasound, Guanghua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China
  • 5 Department of Medical Imaging, Weifang Medical University, Weifang, Shandong Province, China
  • 6 Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 7 Department of Echocardiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 8 Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
  • 9 Department of Ultrasound, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China

The final, formatted version of the article will be published soon.

    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.

    Keywords: Echocardiography, Hypertension, Layer-specific longitudinal strain, Layer-specific circumferential strain, Two-dimensional speckle tracking imaging

    Received: 07 Jul 2024; Accepted: 20 Sep 2024.

    Copyright: © 2024 Chen, Yang, Li, Jin, Wu, Zhang, Du, Luo and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Jianxiong Chen, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
    Xiaohuan Yang, Department of Ultrasound, Shanghai Fourth People's Hospital, Shanghai,, China
    Xinyi Li, Business School, Hubei University, Wuhan, Hebei Province, China
    Lingheng Wu, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
    Mengjiao Zhang, Department of Medical Imaging, Weifang Medical University, Weifang, 261053, Shandong Province, China
    Lianfang Du, Department of Ultrasound, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Xianghong Luo, Department of Echocardiology, Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
    Zhaojun Li, Department of Ultrasound, Jiading Branch of Shanghai General Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China

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