Left Ventricle Strain in Patients with Myocardial Infarction, Ischemic, and Dilated Cardiomyopathy – A Single-center Study

Introduction: Left ventricle (LV) dysfunction is the most important cause of cardiac morbidity and mortality. LV systolic function is conventionally assessed by LV ejection fraction (LVEF). LV longitudinal contraction is the most important contributor to LV systolic function. Evaluation of longitudinal contraction is evaluated by various echocardiographic modalities. Tissue Doppler-derived mitral valve medial and lateral annular s’ velocities’ mean (MV s’) are used to assess LV longitudinal systolic contractility. Recently, speckle tracking-derived global longitudinal strain (GLS) and segmental longitudinal strain (LS) have become the most comprehensive and objective assessment of LV longitudinal contractility. Objective: We aim to assess the usefulness of these ventricular function parameters in myocardial infarction (MI) and dilated and ischemic cardiomyopathies causing LV dysfunction. Methods: A retrospective cross-sectional single-center echocardiographic data of 641 subjects having anterior or inferior wall MI and ischemic or dilated cardiomyopathy was retrieved. Echocardiographic measurements and effort tolerance in Mets were analyzed. Data for 707 normal subjects were taken from an earlier published study on normative echocardiographic measurements of healthy Indians. Results: Our findings show that GLS is the most important parameter for assessing LV systolic function objectively. GLS is also angle-independent and easily reproducible. It is superior to LVEF and MVs. Segmental LS can discriminate coronary artery distribution-related loss of function in MI. Conclusion: GLS and segmental LS are the most important parameters to define the LV function; it is easy to perform, objective, and reproducible.