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=11

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