A new approach to assess myocardial work by non-invasive left ventricular pressure-strain relations in hypertension and dilated cardiomyopathy

Abstract

Myocardial deformation imaging using 2D speckle-tracking echocardiography (STE) has allowed advancements in left ventricular (LV) quantification beyond ejection fraction (EF) as a superior prognostic marker of cardiac events.1-3 However, one of the main limitations of strain imaging is load dependency, which can affect the diagnostic accuracy of myocardial function evaluation.4 An increase in afterload has been proven to decrease strain leading to misinterpretation of the true contractile function.Myocardial work (MW) is a new parameter that takes into account deformation as well as afterload through interpretation of strain in relation to dynamic non-invasive LV pressure, potentially offering incremental value to myocardial function assessment.