| Objective To assess the diagnostic efficacy of pressure-strain loop（PSL） analysis for quantifying left ventricular myocardial work（MW） parameters in apical hypertrophic cardiomyopathy（ApHCM）. Methods Twenty patients with ApHCM who visited the Second Affiliated Hospital of Anhui Medical University from January to June 2024 and 30 volunteers who came to the hospital for health examination were selected. All subjects completed routine echocardiography and obtained left atrial anteroposterior diameter（LAD）, interventricular septum thickness（IVST）, left ventricular posterior wall thickness（LVPWT）, apical wall thickness（AWT）, left ventricular end-diastolic volume（LDEDV）, left ventricular end-systolic volume（LDESV）, left ventricular ejection fraction（LVEF）, mitral diastolic peak velocity（E peak and A peak）, early diastolic peak motion velocity（e'） on the septal and lateral sides of the mitral annulus. PSL technology was used to obtain left ventricular global longitudinal strain（GLS）, peak strain dispersion（PSD）, global work index（GWI）, global useful work（GCW）, global useless work（GWW）, global work efficiency（GWE）, and the segmental work index（WI） and segmental work efficiency（WE） of the basal, middle and apical segments were obtained according to the local myocardial work parameters. The differences in conventional echocardiographic parameters, GLS, PSD, and global and segmental work parameters were compared between the two groups. Results Compared to the control cohort, the ApHCM group exhibited significant decrease in the GLS, GWI, GCW, and GWE. Concurrently, the PSD and GWW showed significant elevation（P＜0.05）. The WI and WE of the basal, middle and apical segments of the ApHCM group were reduced compared with those of the control group（P＜0.05）. The WI and WE of the apical segment were significantly negatively correlated with the apical wall thickness（P＜0.001）. Conclusion PSL can noninvasively assess early-stage systolic dysfunction in ApHCM patients and can quantify the local myocardial work of ApHCM patients with preserved LVEF, providing a new idea for clinical diagnosis and evaluation. |
