The risk stratification of patients with heart failure (HF) can be performed using
echocardiographic parameters such as left ventricular (LV) ejection fraction (LVEF).
Since LVEF reflects merely the change in LV volume but does not take into consideration
ultrastructural changes that may occur at the myocardial level and that may impair
LV systolic performance. Thus, LVEF may not truly represent LV systolic function in
specific cardiac diseases or when subtle LV systolic dysfunction is present. Two-dimensional
speckle-tracking is a post-processing computer algorithm that uses the routine grayscale
digital images, and enables assessment of myocardial strain, thereby providing detailed
information on global and regional active LV deformation. Global longitudinal strain
(GLS), which was defined as the average peak strain of 18 segments from standard apical
views, provides the best evidence on the diagnostic and prognostic implications, and
the ability of GLS to predict cardiovascular outcome may be superior to LVEF. This
presentation reviews the strengths of echocardiographic speckle-tracking strain imaging,
especially GLS, and its current potential for clinical use in patients with HF.
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