{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T11:46:17Z","timestamp":1768736777181,"version":"3.49.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T00:00:00Z","timestamp":1561593600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Speckle tracking advancements make\u00a0now available the analysis of layer\u2010specific myocardial deformation. This study investigated multilayer longitudinal strain in Anderson\u2013Fabry disease (<jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content>) patients at diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a case\u2013control study, 33 newly diagnosed, untreated <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients and 33 healthy age\u2010 and sex\u2010matched healthy controls underwent a complete echocardiogram, including assessment of left ventricular (<jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content>) transmural global longitudinal strain (<jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content>), subendocardial longitudinal strain (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subendo), subepicardial longitudinal strain (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi), and strain gradient (<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subendo\u2013<jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subpepi).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Anderson\u2013Fabry disease patients had similar blood pressure, heart rate, and ejection fraction but higher body mass index in comparison with controls. <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> mass index, maximal, and relative wall thickness were significantly greater in <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients. <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subendo was significantly higher than <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi in both groups, but <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001), <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subendo (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003), and particularly <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi (21.4\u00a0\u00b1\u00a01.7 vs 18.8\u00a0\u00b1\u00a01.4%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001) were lower in <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients than in controls. Accordingly, <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content> gradient was higher in <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003). Three patients symptomatic for dyspnoea presented a combination of <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> hypertrophy and reduced <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi. After adjusting for confounders by multivariate analyses, <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> mass index or maximal wall thickness were independently and inversely associated with transmural <jats:styled-content style=\"fixed-case\">GLS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi, but not with <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subendo in the <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> group. At receiver operating curve curves, <jats:styled-content style=\"fixed-case\">LS<\/jats:styled-content>subepi best discriminated <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> and normals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In newly diagnosed, untreated <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients, layer\u2010specific strain imaging highlights an impairment of <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> longitudinal deformation, mainly involving subepicardial strain and causing increase in longitudinal strain myocardial gradient. These findings could be useful for identifying the mechanisms underlying early <jats:styled-content style=\"fixed-case\">LV<\/jats:styled-content> dysfunction in <jats:styled-content style=\"fixed-case\">AFD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14399","type":"journal-article","created":{"date-parts":[[2019,6,27]],"date-time":"2019-06-27T14:13:38Z","timestamp":1561644818000},"page":"1273-1281","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Layer\u2010specific longitudinal strain in Anderson\u2013Fabry disease\u00a0at diagnosis: A speckle tracking echocardiography analysis"],"prefix":"10.1111","volume":"36","author":[{"given":"Roberta","family":"Esposito","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences University Federico II Naples Italy"},{"name":"Mediterranea Cardiocentro Naples 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