Myocardial Strain Imaging: Theory, Current Practice, and the Future.

Area of Science:

• Cardiology
• Medical Imaging
• Biomedical Engineering

Background:

• Myocardial strain imaging is a key diagnostic tool for cardiac disease.
• It measures myocardial shortening, thickening, and lengthening in any cardiac chamber.
• Left ventricular (LV) global longitudinal strain via speckle-tracking echocardiography is a widely used clinical parameter.

Purpose of the Study:

• To highlight the clinical applications and diagnostic capabilities of myocardial strain imaging.
• To emphasize strain imaging's sensitivity in detecting early systolic dysfunction compared to ejection fraction.
• To explore the utility of strain imaging in various cardiac conditions and chambers.

Main Methods:

• Utilizes echocardiography and cardiac magnetic resonance (CMR) for strain assessment.
• Employs speckle-tracking echocardiography for LV global longitudinal strain measurement.
• Discusses various CMR-based modalities for clinical implementation.

Main Results:

• Global longitudinal strain is more sensitive than ejection fraction for diagnosing mild systolic dysfunction.
• Strain imaging aids in identifying heart failure with normal ejection fraction, valvular disease, and monitoring chemotherapy effects.
• Segmental strain maps assist in diagnosing cardiomyopathies, LV dyssynchrony, and ischemic dysfunction.

Conclusions:

• Strain imaging is a powerful, sensitive tool for diagnosing and monitoring cardiac diseases.
• It offers valuable insights into right ventricular function and left atrial function for diastolic assessment.
• Strain imaging is poised for broader clinical integration across diverse cardiovascular applications.