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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