Figure 1:

Circumferential transmural strain difference (cTSD). This figure illustrates the concept of cTSD in a healthy participant (healthy, top) and one with hypertrophic cardiomyopathy (LVH, bottom). Note that in the hypertrophied myocardium, epicardial shortening (orange) is lower and endocardial shortening (blue) is higher relative to the healthy scan. This divergence is diluted by taking the mean (analogous to midwall strain) but is enhanced by taking the difference (ie, the cTSD). LVH = left ventricular hypertrophy.