We conducted this study to investigate left ventricle (LV) systolic function in endocardial, mid-myocardial, and epicardial layers by two-dimensional (2D) speckle tracking echocardiography (STE) in hypertrophic cardiomyopathy (HCM) patients with myocardial injury indexed by elevated serum cardiac troponin I (cTnI). Twenty-nine HCM patients with myocardial injury, thirty-five HCM patients without myocardial injury, and ninty-one healthy controls were enrolled in this study. Serum cTnI > 0.026 ng/mL was defined as myocardial injury. LV longitudinal and circumferential strain (LS and CS) were assessed in endocardial, mid-myocardial and epicardial layers. Layer-specific LS and CS differed significantly (all P < 0.001) among all three groups in all three layers, in a descending order from healthy controls to HCM patients without myocardial injury to HCM patients with myocardial injury. Layer-specific LS and CS were decreased the most in HCM patients with myocardial injury indexed by elevated seum cTnI (all P < 0.05). In HCM patients with myocardial injury, layer-specific LS and CS were significantly lower in the segments with greater hypertrophy (segmental thickness ≥ 15 mm) (all P < 0.001) except for endocardial CS (P > 0.05). Layer-specific evaluation of LV strain may improve understanding of impaired LV systolic function in HCM patients with myocardial injury, thus preventing further damage.
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The authors thank all the participants for their cooperation and are grateful for the support of Department of Cardiovascular Ultrasound, First Affiliated Hospital of China Medical University.
This study was supported by grants from the National Natural Science Foundation of China (81701703 to D.S.), the Shenyang Science and Technology Plan Project (19-112-4-061 to J.Y.), and the Youth Scholar Supporting Plan Project of China Medical University (QGZD2018039 to W.L.).
Conflict of interest
There is no conflict of interest about this work.
Ethics approval was obtained from the Institutional Ethics Committee of China Medical University. Each participant provided written informed consent after receiving a detailed description of the study.
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Liu, W., Zhang, Y., Liu, Y. et al. Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study based on layer-specific speckle tracking echocardiaography. Int J Cardiovasc Imaging (2020). https://doi.org/10.1007/s10554-020-01921-6
- Hypertrophic cardiomyopathy
- Layer-specific strain
- Myocardial injury