Clinical Utility of Echocardiographic Strain and Strain Rate Measurements

AbstractPurpose of ReviewAssessment of left ventricular function is pivotal in many decisions, but ejection fraction has fundamental limitations for assessment of mild dysfunction, and especially for repeated assessments. Myocardial deformation imaging using speckle-tracking is widely available on modern echocardiography systems, and is now feasible as a clinical, rather than purely a research tool. Strain can be measured in all cardiac chambers, most commonly as a systolic parameter, although it can be measured in diastole. Generally, speckle tracking is more effective at measuring strain than strain-rate, which requires a higher temporal resolution. The purpose of this review is to help clinicians understand the main situations where strain provides incremental value to standard echocardiographic measurements.Recent FindingsThe normal range of LV global longitudinal strain (GLS) has now been defined as −18% and lower (ie more negative), abnormal as −16% or higher (ie less negative), with −16 to −18% being borderline. The variation between different vendors is now small for global parameters, but regional strain measurement remains unreliable – and therefore its use for stress echocardiog raphy remains problematic. The most valuable indications for measuring strain are subclinical LV dysfunction (eg., GLS in HFpEF, stage B heart failure, aortic stenosis, mitral regurgitation), RV dysfunction (RV strain in pulmonary hypertension), atrial fibrillation (LA strain) and...

Source: Current Cardiology Reports - February 16, 2021 Category: Cardiology Source Type: research