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Updated: Mar 9, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Myocardial layer-specific analysis in patients with heterozygous familial hypercholesterolemia using speckle tracking
Zhaoting Leng1, Rongjuan Li1, Yijia Li1
1Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Insights
Layer-specific strain analysis reveals early left ventricular (LV) dysfunction in heterozygous familial hypercholesterolemia (HeFH) patients. This method aids in understanding and preventing LV damage in FH.
Area of Science:
- Cardiology
- Genetics
- Biomedical Engineering
Background:
- Familial hypercholesterolemia (FH) is a common genetic disorder leading to premature coronary heart disease.
- Early detection of left ventricular (LV) dysfunction in FH is crucial but often challenging.
- Traditional assessments may not detect subtle functional changes in asymptomatic FH patients.
Purpose of the Study:
- To investigate the utility of layer-specific strain analysis for assessing early LV functional impairment in asymptomatic heterozygous FH (HeFH) patients with preserved ejection fraction.
- To identify specific strain parameters indicative of subclinical myocardial damage in HeFH.
Main Methods:
- Transthoracic echocardiography was performed on 49 HeFH patients and 32 healthy controls.
- Layer-specific longitudinal and circumferential strain (endocardium, myocardium, epicardium) was analyzed using specialized software.
- Correlation between strain values and lipid levels (Total Cholesterol, LDL Cholesterol) was assessed.
Main Results:
- Patients with HeFH showed significantly reduced endocardial and myocardial longitudinal strain (LSendo, LSmyo).
- Endocardial circumferential strain (CSendo) was also significantly reduced in HeFH patients.
- Reduced strain parameters correlated positively with total cholesterol and LDL cholesterol levels.
Conclusions:
- Layer-specific strain analysis is a valuable tool for detecting early LV impairment in FH patients.
- This technique offers a novel approach to better understand and potentially prevent LV damage progression in FH.
- Early identification of subclinical dysfunction can guide therapeutic strategies to mitigate cardiovascular risk in FH.
Objective:
Familial hypercholesterolemia (FH) is the most common and serious monogenic disorder of lipid metabolism, causing premature coronary heart disease (CHD) due to accelerated atherosclerosis from birth, and the study of left ventricular (LV) function of this disease is seldom. The purpose of this study was to explore the value of layer-specific strain on assessing the early damage of LV function in asymptomatic and left ventricular ejection fraction (LVEF) well-preserved patients with heterozygous FH (HeFH).
Methods:
A total of 49 patients aged 38.7±8.7 diagnosed with heterozygous familial hypercholesterolemia and who had undergone transthoracic echocardiography from 2010 to 2016 were included in this study. A total 32 healthy volunteers aged 35.6±10.3 were included as control group. Longitudinal and circumferential strains of the endocardium, myocardium, and epicardium (LSendo, LSmyo, and LSepi and CSendo, CSmyo, and CSepi) were obtained by a software enabling the analysis of strains in three myocardial layers.
Results:
In longitudinal strain (LS), the LS of endocardium (LSendo) and the LS of myocardium (LSmyo) are significantly reduced in patients with HeFH (P<.001 in both). In circumferential strain (CS), only the CS of endocardium (CSendo) is significantly reduced (P<.001). The degree of reduction in strain is positively correlated with the TC and LDLC.
Conclusions:
Layer-specific evaluation of the left ventricle has great value in evaluating early impairment of LV in patients with FH. And this relatively novel technique may made it possible to help us understand the process of LV impairment in patients with FH better, thus preventing further damage.
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