Longitudinal Strain

SEE PAGE 1351 F or decades, echocardiography has proved to be a well-established noninvasive imaging modality for bedside assessment of global left ventricular (LV) function in patients with heart failure (HF). The need for objective quantification of systolic LV pump function for prognostic purposes has led to the development of numerous echocardiographic indexes. LV ejection fraction (EF) is the most studied and clinically applied index of LV systolic function. Measurement of LVEF is currently the mainstay for many clinical and therapeutic decisions, while it is also widely used to decide on patient inclusion in large clinical trials. Despite the introduction of 3-dimensional echocardiography allowing more direct LV volume measurement than conventional 2-dimensional (2D) methods, poor reproducibility of echocardiographic EF measurement remains a critical issue. Furthermore, it is well recognized that the prognostic value of volumetric LV systolic function assessment is limited in patients with HF and preserved LVEF. The introduction of speckle tracking echocardiography (STE) enabled direct measurement of myocardial tissue deformation from conventional 2D B-mode images. Several studies have shown the usefulness of STE-derived global longitudinal strain (GLS) as a replacement of or an addition to LVEF for the prediction of outcome in different subgroups of HF patients (1–3).