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Subclinical left ventricular dysfunction assessed by two-dimensional speckle tracking echocardiography in asymptomatic patients with carotid stenosis

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Abstract

The relationship between subclinical left ventricular (LV) dysfunction and atherosclerosis may have been underestimated in the past, which might be responsible for the high incidence of premature death in individuals with carotid stenosis. We sought to evaluate the underlying myocardial dysfunction in asymptomatic carotid stenosis patients using speckle tracking echocardiography (STE). Fifty patients with carotid stenosis ≥ 50% and a preserved LV ejection fraction (LVEF), and 45 controls without carotid stenosis who were matched in terms of vascular comorbidities were enrolled. All participants underwent carotid ultrasound and echocardiographic examination. The global LV longitudinal strain (GLS) was measured using STE. Compared with the control group, the e’ of the mitral annular velocity and GLS were decreased in asymptomatic carotid stenosis patients (p < 0.05), however, the LVEF was well preserved. Based on a predefined cutoff for subclinical LV systolic dysfunction that was defined at a GLS <  − 18%, this dysfunction was detected in 22 patients with carotid stenosis (44%) and in 10 patients in the control group (22%) (p < 0.05). The GLS was negatively correlated with the levels of low-density lipoprotein cholesterol (r =  − 0.356, p < 0.05) and triglyceride (r =  − 0.396, p < 0.05). In conclusion, LV diastolic and systolic functioning were significantly decreased in patients with asymptomatic carotid stenosis, and dyslipidemia likely contributed to the subclinical LV dysfunction in these patients. Our findings indicated the importance of detecting LV subclinical dysfunction and early intervention in this patient population.

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Funding

This study was supported by the National Natural Science Foundation of China (81701699) and the Doctoral Initiate Foundation of Liaoning (20170520053).

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Authors and Affiliations

  1. Department of Ultrasound, Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, 110032, People’s Republic of China

    Linwei Hong

  2. Department of Chronic Disease, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, 110005, People’s Republic of China

    Liying Xing

  3. Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, People’s Republic of China

    Ru Li, Limin Zhang, Chunyan Ma, Lanting Zhao, Jun Yang & Shuang Liu

  4. Department of Ultrasound, Second Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, 110034, People’s Republic of China

    Jing An

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  1. Linwei Hong
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Hong, L., Xing, L., Li, R. et al. Subclinical left ventricular dysfunction assessed by two-dimensional speckle tracking echocardiography in asymptomatic patients with carotid stenosis. Int J Cardiovasc Imaging 35, 2205–2212 (2019). https://doi.org/10.1007/s10554-019-01677-8

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  • DOI: https://doi.org/10.1007/s10554-019-01677-8

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