Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, People's Republic of China.
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University. Beijing, People's Republic of China.
Tex Heart Inst J. 2021 Jun 1;48(2). doi: 10.14503/THIJ-18-6720.
Myocardial ischemia and left ventricular dysfunction have been documented in young adults with familial hypercholesterolemia. We investigated whether speckle-tracking echocardiography can be used to detect subclinically impaired global and regional myocardial function in patients with this lipid disorder. This single-center study included 47 patients with familial hypercholesterolemia and 37 healthy control subjects who underwent transthoracic Doppler echocardiography and speckle-tracking echocardiography from January 2003 through December 2016. Conventional echocardiographic and strain parameters in the 2 groups were analyzed and compared. Left ventricular dimensions were significantly larger at end-diastole (P=0.02) and end-systole (P=0.013), left ventricular walls were significantly thicker (P <0.0001), and the early transmitral/early diastolic mitral annular velocity ratio was significantly higher (P=0.006) in the patient group than in the control group. In the patient group, global longitudinal and circumferential strain values were significantly lower (P <0.0001) and global radial strain values significantly higher (P=0.006); all segmental longitudinal strain (P <0.04) and most segmental circumferential strain values (P ≤0.01) were significantly lower; and some segmental radial strains, especially at the apex, were significantly higher (P ≤0.04). However, average longitudinal, circumferential, and radial strains in the different segments of the 3 main coronary artery territories were significantly lower in the patient group (P <0.01). Global longitudinal strain (r=0.561; P=0.001) and global circumferential strain (r=0.565; P <0.0001) were inversely correlated with low-density-lipoprotein cholesterol levels. We conclude that speckle-tracking echocardiography can be used to detect subclinical global and regional systolic abnormalities in patients with familial hypercholesterolemia.
家族性高胆固醇血症的年轻患者中已发现心肌缺血和左心室功能障碍。我们研究了斑点追踪超声心动图是否可用于检测此类脂质异常患者亚临床的整体和局部心肌功能障碍。这项单中心研究纳入了 2003 年 1 月至 2016 年 12 月期间进行经胸多普勒超声心动图和斑点追踪超声心动图检查的 47 例家族性高胆固醇血症患者和 37 名健康对照者。分析和比较了两组的常规超声心动图和应变参数。结果显示，患者组舒张末期（P=0.02）和收缩末期（P=0.013）左心室舒张末期和收缩末期左心室尺寸显著增大，左心室壁明显增厚（P <0.0001），且早期二尖瓣前向血流/早期舒张期二尖瓣环速度比值明显更高（P=0.006）。与对照组相比，患者组的整体纵向应变和环向应变值显著降低（P <0.0001），整体径向应变值显著升高（P=0.006）；所有节段性纵向应变（P <0.04）和大多数节段性环向应变值（P ≤0.01）均显著降低，特别是心尖部的一些节段性径向应变值显著升高（P ≤0.04）。然而，患者组 3 个主要冠状动脉区域不同节段的平均纵向、环向和径向应变值显著降低（P <0.01）。患者组的整体纵向应变（r=0.561；P=0.001）和整体环向应变（r=0.565；P <0.0001）与低密度脂蛋白胆固醇水平呈负相关。综上，斑点追踪超声心动图可用于检测家族性高胆固醇血症患者亚临床的整体和局部收缩异常。
