Myocardial strain imaging – pro
Technology has evolved to the point where areas of the heart can be observed at markedly increased frame rates, an evolution that allows us to measure segmental deformation. These techniques now are commonly referred to as strain imaging. Strain is the normalized, dimensionless measure of deformation of a segment of myocardium in response to an applied force or stress. In cardiac imaging, we can now measure the rate of deformation of the ventricular wall in various dimensions, providing a new facet in our endeavor to appreciate early myocardial dysfunction. Significant progress has been achieved with the use of this technology, but in terms of user confidence regarding uniformity and its ability to provide meaningful, consistent results, strain has not yet been fully accepted into the clinician’s armamentarium. Basic challenges, including image quality, persist, as do variances between the different devices that are currently available. To move us farther, a joint standardization task force between professional societies and industry was initiated in 2010 to reduce the inter-vendor variability of strain measures, and these efforts have produced some initial results. The American College of Cardiology set forth eh position that more refinement and evolution of this technique is expected, but says that ” it is time for strain to join the mainstream of noninvasive cardiac techniques and assist us in the management of our clinically challenging patients to whom we must provide the most advanced and sophisticated methods to assist them in their battles against cancer.”
Smiseth OA, Torp H2, Opdahl A, Haugaa KH, Urheim S.Myocardial strain imaging: how useful is it in clinical decision making? Eur Heart J. 2016 Apr 14;37(15):1196-207.
Michael S. Ewer, MD, JD, PhD; Jose A. Banchs, MD, FAC, C, Strain Echocardiography: Routine Strain Analysis is Ready for Clinical Purposes
Oct 31, 2017 http://www.acc.org/latest-in-cardiology/articles/2017/10/31/09/57/strain-echocardiography