Related Experiment Video
Updated: Mar 14, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Improved detection of myocardial damage in sarcoidosis using longitudinal strain in patients with preserved left
Gillian Murtagh1, Luke J Laffin1, Kershaw V Patel1
1Department of Medicine and Radiology, University of Chicago Medical Center, Chicago, Illinois.
Insights
Global longitudinal strain (GLS) measured by echocardiography can identify cardiac sarcoidosis (CS) in patients with preserved ejection fraction. Abnormal GLS also predicts major cardiovascular events in individuals with sarcoidosis.
Area of Science:
- Cardiology
- Medical Imaging
- Pulmonology
Background:
- Cardiac sarcoidosis (CS) is a significant cause of mortality in sarcoidosis patients.
- Transthoracic echocardiography (TTE) has limited sensitivity for CS detection.
- Late gadolinium enhancement cardiovascular magnetic resonance (CMR) is effective but costly and less accessible.
Purpose of the Study:
- To evaluate TTE-derived global longitudinal strain (GLS) for identifying CS in patients with preserved left ventricular ejection fraction (LVEF).
- To determine if abnormal GLS is associated with major cardiovascular events (MCE).
Main Methods:
- Studied 62 patients with biopsy-proven sarcoidosis, divided into CS+ (LGE on CMR) and CS- groups.
- Measured GLS using speckle tracking software; analyzed other ventricular function parameters.
- Used ROC curves for GLS cutoff and Kaplan-Meier plots for MCE prediction.
Main Results:
- Reduced GLS was significantly associated with LGE (CS+) and higher LGE burden.
- A GLS cutoff of -17% demonstrated 94% sensitivity and specificity for CS detection.
- Worse GLS was observed in patients who experienced MCE.
Conclusions:
- Significantly reduced GLS is linked to CS in patients with preserved LVEF.
- GLS may become a valuable tool in TTE for screening CS.
- GLS has potential for predicting cardiovascular events in sarcoidosis.
Background:
Cardiac infiltration is an important cause of death in sarcoidosis. Transthoracic echocardiography (TTE) has limited sensitivity for the detection of cardiac sarcoidosis (CS). Late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) is used to diagnose CS but has limitations of cost and availability. We sought to determine whether TTE-derived global longitudinal strain (GLS) may be used to identify individuals with CS, despite preserved left ventricular ejection fraction (LVEF), and whether abnormal GLS is associated with major cardiovascular events (MCE).
Methods:
We studied 31 patients with biopsy-proven extra-cardiac sarcoidosis, LVEF>50% and LGE on CMR (CS+ group), and 31 patients without LGE (CS- group), matched by age, sex, and severity of lung disease. GLS was measured using vendor-independent speckle tracking software. Parameters of left and right ventricular systolic and diastolic function were also studied. Receiver-operating characteristic curves were used to identify GLS cutoff for CS detection, and Kaplan-Meier plots to determine the ability of GLS to predict MCE.
Results:
LGE was associated with reduced GLS (-19.6±1.9% in CS- vs -14.7±2.4% in CS+, P<.01) and with reduced E/A ratio (1.1±0.3 vs 0.9±0.3, respectively, P =.01). No differences were noted in other TTE parameters. GLS magnitude inversely correlated with LGE burden (r=-.59). GLS cutoff of -17% showed sensitivity and specificity 94% for detecting CS. Patients who experienced MCE had worse GLS than those who did not (-13.4±0.9% vs -17.7±0.4%, P=.0003).
Conclusions:
CS is associated with significantly reduced GLS in the presence of preserved LVEF. GLS measurements may become part of the TTE study performed to screen for CS.
More Related Videos
11:50High-frequency High-resolution Echocardiography: First Evidence on Non-invasive Repeated Measure of Myocardial Strain, Contractility, and Mitral Regurgitation in the Ischemia-reperfused Murine Heart
Published on: July 9, 2010
07:21Magnetic Resonance Derived Myocardial Strain Assessment Using Feature Tracking
Published on: February 12, 2011
Related Concept Videos
01:22Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...