Serial ejection fraction (EF) and circumferential strain (ε
). Red, indicates decreased EF and εcc magnitude; blue, indicates increase EF and εcc magnitude and black, indicates mean EF and εcc values. Panels A-C show EF of each subject plotted serially; there was no significant change in mean EF across all three groups. Individually 14/28 (50%) in Group A, 21/31(68%) in Group B and 5/11 (45%) in Group A to B transition had decrease EF, while 14/28 (50%), 10/31 (32%) and 6/11 (55%) of the individuals in the respective groups had increase EF. Panels D-F show εcc of each subject plotted serially; although all three groups had lower absolute εcc on the follow-up study, only Group B subjects had a significant decline (p = 0.007). Individually εcc magnitude decreased more consistently across all three groups, with 24/28 (86%) in Group A, 26/31 (84%) in Group B and 9/11 (82%) in Group A to B. Unlike EF, only a small fraction of the individuals have improvement of εcc magnitude on follow-up study with 4/28 (14%), 5/31 (31%) and 2/11 (18%) of the individuals in the respective group having an increase εcc value on follow-up study.