Clinical Application of Speckle-tracking Echocardiography in Atherosclerotic Cardiovascular Disease

With aging societies, heart failure (HF) is a growing public health concern, particularly HF with a preserved left ventricular ejection fraction (HFpEF). Patients with atherosclerotic cardiovascular disease (ASCVD) are at an increased risk of incident HF, while the prediction of individual risk remains challenging. Speckle-tracking echocardiography enables an objective and quantitative assessment of subtle myocardial alterations that are undetectable with conventional echocardiography and has excellent feasibility and reproducibility. Left ventricular global longitudinal strain (LVGLS), a sensitive measure of LV systolic dysfunction, has been found to be an independent risk factor for the occurrence of HF. In addition, more than 50% of patients with HFpEF had impaired LVGLS. Recently, deformation imaging has been employed to assess left atrial (LA) performance, and impaired LA strain has been shown to predict unfavorable outcomes in various clinical settings. This review article presents the clinical relevance of subclinical left heart dysfunction in patients with ASCVD and describes its future perspectives.