Key result
Speckle-tracking echocardiography detects subclinical systolic abnormalities and lower global strain in familial hypercholesterolemia.
Why the study?
Myocardial ischemia and left ventricular dysfunction occur in young adults with familial hypercholesterolemia, but whether speckle-tracking echocardiography can detect subclinical global and regional myocardial impairment was unknown.
Does speckle-tracking echocardiography detect subclinical global and regional systolic abnormalities in patients with familial hypercholesterolemia compared to healthy controls?
Case-Control (n=84)
No
Does speckle-tracking echocardiography detect subclinical global and regional systolic abnormalities in patients with familial hypercholesterolemia compared to healthy controls?
p-value: p=<0.0001
Speckle-tracking echocardiography can detect subclinical global and regional systolic abnormalities in patients with familial hypercholesterolemia.
Speckle-tracking may detect early systolic impairment in FH; leaves open whether strain adds prognostic value or alters management.
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.
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Li et al. (2021) conducted a case-control in Familial Hypercholesterolemia (n=84). Speckle-tracking echocardiography vs. Healthy control subjects was evaluated on Global longitudinal and circumferential strain (p=<0.0001). Speckle-tracking echocardiography detected subclinical systolic abnormalities in familial hypercholesterolemia, showing significantly lower global longitudinal and circumferential strain (P<0.0001).
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