Myocardial work: The analytical methodology and clinical utilities

Area of Science:

• Cardiology and cardiovascular research.
• Medical imaging and diagnostics.
• Physiology and biomechanics.

Background:

• Left ventricular (LV) systolic function evaluation is crucial in cardiology.
• Left ventricular ejection fraction (LVEF) has limitations; LV strain is sensitive but load-dependent.
• Invasive pressure-volume loops are accurate but risky; non-invasive methods are needed.

Purpose of the Study:

• To review the method, applications, advantages, and limitations of myocardial work (MW).
• To highlight MW as an advanced tool for evaluating LV systolic function.
• To promote the clinical integration of MW in cardiovascular disease management.

Main Methods:

• Utilizes non-invasive left ventricular pressure-strain loops (LV-PSL).
• Combines global longitudinal strain with non-invasive LV systolic pressure.
• Integrates myocardial deformation and hemodynamics.

Main Results:

• Myocardial work (MW) derived from LV-PSL shows good agreement with myocardial metabolism.
• MW is a more advanced tool than traditional echocardiographic parameters or LV strain.
• MW offers novel insights into LV systolic function across various cardiovascular diseases.

Conclusions:

• Myocardial work represents a significant advancement in assessing LV systolic function.
• MW provides a more comprehensive evaluation by combining strain and pressure data.
• Further research and clinical adoption of MW are encouraged for improved patient care.