Abstract
Importance: The cornerstones of imaging in heart failure (HF) are the measurement of systolic and diastolic function and left ventricular (LV) filling pressure. Observations: Ejection fraction and the assessment of LV filling pressure and diastolic dysfunction using the ratio of early transmitral flow and LV relaxation (E/e′) are conventional imaging markers of LV function. Despite their extensive use in HF guidelines, both have significant detractions, especially in an era when HF with preserved ejection fraction is becoming the dominant presentation. In contrast, strain imaging has provided a new window into myocardial mechanics. Myocardial strain is now well validated, robust, and can easily be performed on most modern echocardiography machines. This Review summarizes the evidence in 9 situations across the stages of HF where LV global longitudinal strain and other strain parameters may provide information on risk prediction, diagnosis, assessment of treatment response, and follow-up. Conclusions and Relevance: The evolution of myocardial deformation imaging from research tool to clinical practice will provide clinicians with a useful additional imaging parameter to facilitate the assessment and risk evaluation of patients with HF.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 287-294 |
| Number of pages | 8 |
| Journal | JAMA cardiology |
| Volume | 4 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2019 |
Funding
received research support from the National Health and Medical Research Council (grants 1119955, 1080582, 1059738, and 1149692) and General Electric Medical Systems for an ongoing research study on the use of strain for the assessment of cardiotoxicity. Dr Shah has received funding from the National Institutes of Health (grants R01 HL127028, R01 HL107577, and R01 HL140731), Actelion Pharmaceuticals, AstraZeneca, Corvia Medical, and Novartis as well as consulting fees from Actelion Pharmaceuticals, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Cardiora, Eisai, Ironwood Pharmaceuticals, Merck & Co, Novartis, Pfizer, Sanofi, and United Therapeutics. Dr Thomas has received consulting fees and honoraria from General Electric, Edwards Lifesciences, Abbott Laboratories, and Bay Labs, and his spouse is employed by Bay Labs.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine