Assessment of left ventricular myocardial systolic dysfunction in
premature ovarian insufficiency using echocardiographic layer-specific
myocardial strain imaging
Abstract
Objective: To explore the myocardial systolic dysfunction in premature
ovarian insufficiency (POI) patients with normal left ventricular
ejection fraction (LVEF) using echocardiographic layer-specific
myocardial strain imaging. Methods: Forty-eight newly diagnosed,
untreated POI patients with normal LVEF (POI group) and fifty healthy
female volunteers with matching age, height and weight (controls group)
were enrolled. Both groups underwent standard transthoracic
echocardiography to obtain conventional left ventricular and
layer-specific strain parameters, the layer-specific strain parameters
including the subendomyocardial global longitudinal strain (GLSendo),
the mid-layer myocardial global longitudinal strain (GLSmid), the
subepimyocardial global longitudinal strain (GLSepi), the
subendomyocardial global circumferential strain (GCSendo), the mid-layer
myocardial global circumferential strain (GCSmid), and the
subepimyocardial global circumferential strain (GCSepi). Results: The
end-diastolic interventricular septal thickness (IVST) in the POI group
was significantly thicker than that in the controls group (P=0.008), and
The E, E/A, lateral e′ in POI group were significantly lower than those
in the controls group (P<0.05). The GLSendo, GLSmid, GLSepi,
GCSendo, GCSmid, and GCSepi in the POI group were significant lower than
those in the controls group (P<0.05). Receiver operating characteristic
(ROC) curve showed that the area under the curve (AUC) of GLSepi was the
largest in diagnosing impaired left ventricular systolic function in POI
patients (AUC=0.706, P=0.000). Conclusions: POI patients with normal
LVEF may suffer with subclinical left ventricular myocardial systolic
dysfunction. The echocardiographic layer-specific myocardial strain
could be more sensitive to be used to detect the subclinical impairment
of left ventricular systolic function in POI patients.