Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2024, 33(6):359-370

Left ventricular global longitudinal strain in the evaluation of left ventricular heart failure and ischaemic heart disease in modern echocardiography

Yashar Jalali, Jan Stevlik, Gabriel Kamensky, Monika Jalali, Juraj Payer
Faculty of Medicine, Comenius University in Bratislava, and 5th Department of Internal Medicine, University Hospital Bratislava, Ružinov, Bratislava, Slovakia

Since its introduction into echocardiology around 20 years ago, speckle tracking (ST) has developed significantly, finding its place in daily clinical practice. Many applications have been tested and proposed for different modalities of ST. Longitudinal strain (LS) and, specifically, global longitudinal strain (GLS) have become the most utilised and studied modalities of ST. Due to their diagnostic/treatment complexities, heart failure (HF) and ischaemic heart disease (IHD) have become an important domain for the development of GLS. In recent years, many clinical studies, meta-analyses, and systematic reviews have tried to define the clinical applications of GLS in these pathologies and estimate its reliability and predictive value for diagnostic/prognostic purposes. The results from these studies have prompted international institutes such as the European Society of Cardiology (ESC) and the American Society of Echocardiography (ASE) to add GLS to the diagnostic protocols in their recent guidelines. In this review we examine this novel, advanced, echocardiographic method and discuss its most relevant clinical applications in HF and IHD.

Keywords: speckle tracking; global longitudinal strain; echocardiography; heart failure ischaemic heart disease; left ventricular systolic function

Published: June 1, 2024  Show citation

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Jalali Y, Stevlik J, Kamensky G, Jalali M, Payer J. Left ventricular global longitudinal strain in the evaluation of left ventricular heart failure and ischaemic heart disease in modern echocardiography. Cardiology Letters. 2024;33(6):359-370.
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    References

    1. Reisner SA, Lysyansky P, Agmon Y, Mutlak D, Lessick J, Friedman Z. Global longitudinal strain: a novel index of left ventricular systolic function. J Am Soc Echocardiogr. 2004;17:630-633. Go to original source...
    2. Farsalinos KE, Daraban AM, Ünlü S, Thomas JD, Badano LP, Voigt JU. Head-to-Head Comparison of Global Longitudinal Strain Measurements among Nine Different Vendors: The EACVI/ ASE Inter-Vendor Comparison Study. J Am Soc Echocardiogr. 2015;28:1171-1181, e2. Go to original source...
    3. Sade LE, Joshi SS, Cameli M, Cosyns B, Delgado V, Donal E, et al. Current clinical use of speckle-tracking strain imaging: insights from a worldwide survey from the European Association of Cardiovascular Imaging (EACVI). Eur Heart J Cardiovascular Imaging. 2023;24:1583-1592. Go to original source...
    4. Lin Y, Zhang L, Hu X, Gao L, Ji M, He Q, et al. Clinical Usefulness of Speckle-Tracking Echocardiography in Patients with Heart Failure with Preserved Ejection Fraction. Diagnostics. 2023;13:2923. Go to original source...
    5. Collet JP, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42:1289-1367. Go to original source...
    6. Negishi T, Negishi K, Thavendiranathan P, Cho GY, Popescu BA, Vinereanu D, et al. Effect of Experience and Training on the Concordance and Precision of Strain Measurements. JACC Cardiovasc Imaging. 2017;10:518-522. Go to original source...
    7. Ersbøll M, Valeur N, Mogensen UM, Andersen MJ, Møller JE, Hassager C, et al. Relationship between left ventricular longitudinal deformation and clinical heart failure during admission for acute myocardial infarction: a two-dimensional speckle-tracking study. J Am Soc Echocardiogr. 2012;25:1280-1289. Go to original source...
    8. Sjøli B, Ørn S, Grenne B, Ihlen H, Edvardsen T, Brunvand H. Diagnostic capability and reproducibility of strain by Doppler and by speckle tracking in patients with acute myocardial infarction. JACC Cardiovasc Imaging. 2009;2:24-33. Go to original source...
    9. Houard L, Militaru S, Tanaka K, Pasquet A, Vancraeynest D, Vanoverschelde JL, et al. Test-retest reliability of left and right ventricular systolic function by new and conventional echocardiographic and cardiac magnetic resonance parameters. Eur Heart J Cardiovasc Imaging. 2021;22:1157-1167. Go to original source...
    10. Collier P, Phelan D, Klein A. A Test in Context: Myocardial Strain Measured by Speckle-Tracking Echocardiography. J Am Coll Cardiol. 2017;69:1043-1056. Go to original source...
    11. Luo Y, Liu Y, Guan X, Zhang Y, Li J. Value of three dimensional speckle-tracking imaging for predicting left ventricular function after non-ST-segment elevation myocardial infarction with percutaneous coronary intervention. J Xray Sci Technol. 2018;26:331-339. Go to original source...
    12. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1-39. e14. Go to original source...
    13. Seo Y, Ishizu T, Atsumi A, Kawamura R, Aonuma K. Threedimensional speckle tracking echocardiography. Circ J. 2014;78:1290-1301. Go to original source...
    14. Nagata Y, Takeuchi M, Wu VC, Izumo M, Suzuki K, Sato K, et al. Prognostic value of LV deformation parameters using 2D and 3D speckle-tracking echocardiography in asymptomatic patients with severe aortic stenosis and preserved LV ejection fraction. JACC Cardiovasc Imaging. 2015;8:235-245. Go to original source...
    15. Shah AM, Claggett B, Sweitzer NK, Shah SJ, Anand IS, Liu L, et al. Prognostic Importance of Impaired Systolic Function in Heart Failure With Preserved Ejection Fraction and the Impact of Spironolactone. Circulation. 2015;132:402-414. Go to original source...
    16. Smiseth OA, Torp H, Opdahl A, Haugaa KH, Urheim S. Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J. 2016;37:1196-1207. Go to original source...
    17. Santos J, Pires I, Neto V, Goncalves L, Correia J, Almeida I, et al. Global longitudinal strain as a predictor of cardiovascular events and mortality in patients with ischemic heart disease and heart failure with preserved/mid-range ejection fraction. Eur Heart J. 2021;42(Supplement_1). Go to original source...
    18. Rodrigues T, Raposo SC, Brito D, Lopes LR. Prognostic relevance of exercise testing in hypertrophic cardiomyopathy. A systematic review. Int J Cardiol. 2021;339:83-92. Go to original source...
    19. Tops LF, Delgado V, Marsan NA, Bax JJ. Myocardial strain to detect subtle left ventricular systolic dysfunction. Eur J Heart Fail. 2017;19:307-313. Go to original source...
    20. Brann A, Miller J, Eshraghian E, Park JJ, Greenberg B. Global longitudinal strain predicts clinical outcomes in patients with heart failure with preserved ejection fraction. Eur J Heart Fail. 2023;25:1755-1765. Go to original source...
    21. Chimed S, Stassen J, Galloo X, Meucci MC, Knuuti J, Delgado V, et al. Prognostic Relevance of Left Ventricular Global Longitudinal Strain in Patients With Heart Failure and Reduced Ejection Fraction. Am J Cardiol. 2023;202:30-40. Go to original source...
    22. Kamperidis V, Marsan NA, Delgado V, Bax JJ. Left ventricular systolic function assessment in secondary mitral regurgitation: left ventricular ejection fraction vs. speckle tracking global longitudinal strain. Eur Heart J. 2016;37:811-816. Go to original source...
    23. Pio SM, Medvedofsky D, Stassen J, Delgado V, Namazi F, Weissman NJ, et al. Changes in Left Ventricular Global Longitudinal Strain in Patients With Heart Failure and Secondary Mitral Regurgitation: The COAPT Trial. Journal of the American Heart Association. 2023;12:e029956. Go to original source...
    24. Li CM, Li C, Bai WJ, Zhang XL, Tang H, Qing Z, et al. Value of threedimensional speckle-tracking in detecting left ventricular dysfunction in patients with aortic valvular diseases. J Am Soc Echocardiogr. 2013;26:1245-1252. Go to original source...
    25. Tatsumi K, Tanaka H, Matsumoto K, Sawa T, Miyoshi T, Imanishi J, et al. Global endocardial area change rate for the assessment of left ventricular relaxation and filling pressure: using 3-dimensional speckle-tracking study. Int J Cardiovasc Imaging. 2014;30:1473-1481. Go to original source...
    26. Zhu M, Chen H, Fulati Z, Liu Y, Su Y, Shu X. The value of left ventricular strain-volume loops in predicting response to cardiac resynchronization therapy. Cardiovascular Ultrasound. 2019;17:3. Go to original source...
    27. Pastore MC, Mandoli GE, Contorni F, Cavigli L, Focardi M, D'Ascenzi F, et al. Speckle Tracking Echocardiography: Early Predictor of Diagnosis and Prognosis in Coronary Artery Disease. Biomed Res Int. 2021;2021:6685378. Go to original source...
    28. Sedlak TL, Lee M, Izadnegahdar M, Merz CN, Gao M, Humphries KH. Sex differences in clinical outcomes in patients with stable angina and no obstructive coronary artery disease. Am Heart J. 2013;166:38-44. Go to original source...
    29. Elhendy A, van Domburg RT, Bax JJ, Roelandt JR. Significance of resting wall motion abnormalities in 2-dimensional echocardiography in patients without previous myocardial infarction referred for pharmacologic stress testing. J Am Soc Echocardiogr. 2000;13:1-8. Go to original source...
    30. Biering-Sørensen T, Hoffmann S, Mogelvang R, Zeeberg Iversen A, Galatius S, Fritz-Hansen T, et al. Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography Improves Diagnostics of Coronary Artery Stenosis in Stable Angina Pectoris. Circulation: Cardiovascular Imaging. 2014;7:58-65. Go to original source...
    31. Billehaug Norum I, Ruddox V, Edvardsen T, Otterstad JE. Diagnostic accuracy of left ventricular longitudinal function by speckle tracking echocardiography to predict significant coronary artery stenosis. A systematic review. BMC Medical Imaging. 2015;15:25. Go to original source...
    32. Abdelrazek G, Yassin A, Elkhashab K. Correlation between global longitudinal strain and SYNTAX score in coronary artery disease evaluation. The Egyptian Heart Journal. 2020;72:22. Go to original source...
    33. Liou K, Negishi K, Ho S, Russell EA, Cranney G, Ooi SY. Detection of Obstructive Coronary Artery Disease Using Peak Systolic Global Longitudinal Strain Derived by Two-Dimensional Speckle-Tracking: A Systematic Review and Meta-Analysis. J Am Soc Echocardiogr. 2016;29:724-35.e4. Go to original source...
    34. Ng ACT, Sitges M, Pham PN, Tran DT, Delgado V, Bertini M, et al. Incremental value of 2-dimensional speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography. American Heart Journal. 2009;158:836-844. Go to original source...
    35. Knuuti J, Wijns W, Saraste A, Capodanno D, Barbato E, FunckBrentano C, et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2020;41:407-477. Go to original source...
    36. Atici A, Barman HA, Durmaz E, Demir K, Cakmak R, Tugrul S, et al. Predictive value of global and territorial longitudinal strain imaging in detecting significant coronary artery disease in patients with myocardial infarction without persistent STsegment elevation. Echocardiography. 2019;36:512-520. Go to original source...
    37. D'Andrea A, Cocchia R, Caso P, Riegler L, Scarafile R, Salerno G, et al. Global longitudinal speckle-tracking strain is predictive of left ventricular remodeling after coronary angioplasty in patients with recent non-st elevation myocardial infarction. International Journal of Cardiology. 2011;153:185-191. Go to original source...
    38. Ersbøll M, Valeur N, Mogensen UM, Andersen MJ, Møller JE, Hassager C, et al. Relationship between Left Ventricular Longitudinal Deformation and Clinical Heart Failure during Admission for Acute Myocardial Infarction: A Two-Dimensional Speckle-Tracking Study. JASE. 2012;25:1280-1289. Go to original source...
    39. Diao KY, Yang ZG, Ma M, He Y, Zhao Q, Liu X, et al. The Diagnostic Value of Global Longitudinal Strain (GLS) on Myocardial Infarction Size by Echocardiography: A Systematic Review and Meta-analysis. Sci Rep. 2017;7:10082. Go to original source...
    40. Eek C, Grenne B, Brunvand H, Aakhus S, Endresen K, Smiseth OA, et al. Strain echocardiography predicts acute coronary occlusion in patients with non-ST-segment elevation acute coronary syndrome. Eur J Echocardiogr. 2010;11:501-508. Go to original source...
    41. Ersbøll M, Valeur N, Mogensen UM, Andersen MJ, Møller JE, Velazquez EJ, et al. Prediction of all-cause mortality and heart failure admissions from global left ventricular longitudinal strain in patients with acute myocardial infarction and preserved left ventricular ejection fraction. J Am Coll Cardiol. 2013;61:2365-2373. Go to original source...
    42. Zito C, Longobardo L, Citro R, Galderisi M, Oreto L, Carerj ML, et al. Ten Years of 2D Longitudinal Strain for Early Myocardial Dysfunction Detection: A Clinical Overview. BioMed Research International. 2018;2018:8979407. Go to original source...
    43. Brainin P, Hoffmann S, Fritz-Hansen T, Olsen FJ, Jensen JS, BieringSørensen T. Usefulness of Postsystolic Shortening to Diagnose Coronary Artery Disease and Predict Future Cardiovascular Events in Stable Angina Pectoris. J Am Soc Echocardiogr. 2018;31:870-9.e3. Go to original source...
    44. Cameli M, Mondillo S, Righini FM, Lisi M, Dokollari A, Lindqvist P, et al. Left Ventricular Deformation and Myocardial Fibrosis in Patients With Advanced Heart Failure Requiring Transplantation. J Card Fail. 2016;22:901-907. Go to original source...
    45. Choi SW, Park JH, Sun BJ, Park Y, Kim YJ, Lee IS, et al. Impaired two-dimensional global longitudinal strain of left ventricle predicts adverse long-term clinical outcomes in patients with acute myocardial infarction. Int J Cardiol. 2015;196:165167. Go to original source...

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