Association Between Myocardial Layer-specific Strain and High 10-year Risk of Atherosclerotic Cardiovascular Disease in Hypertension-findings from the China-PAR Project Study
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Objectives: 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).
Methods: The parameters of LV structure, including layer-specific global longitudinal strain (GLS, GLS, GLS, GLS) and layer-specific global circumferential strain (GCS, GCS, GCS, GCS), 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.
Results: The values of GLS, GLS, GLS, and GLS were significantly lower in HP patients with HR than in HP patients with LR and controls ( 0.05). However, no significant differences in layer-specific GCS were observed between the groups ( > 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 ( 0.156, 0.042), GLS ( 0.161, 0.032), GCS ( 0.163, 0.024), and GCS ( = -0.175, 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. GCS 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.