Early Marker of Myocardial Deformation in Children with Duchenne Muscular Dystrophy Assessed Using Echocardiographic Myocardial Strain Analysis.

At all myocardial levels, three-layer circumferential strain in the abnormally contracting segments was lower than in the corresponding intact segments, while at the basal epicardial layer, this difference was of borderline significance. 9 Circumferential strain behaves in a different way, with a basal-to-apical gradient in all three myocardial layers; thus, the radius of curvature toward the apex for circumferential strain decreases. 12 LV myocardial architecture has been represented as a muscle band continuum, spatially organized such that the right-handed helical geometry in the subendocardial region gradually changes to left-handed geometry in the subepicardial region.

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