What does this research mean for the field?

Left ventricular global longitudinal strain values are not directly interchangeable between fast Strain-ENCoded imaging and post-processing methods, despite moderate agreement. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to compare left ventricular strain values assessed by different techniques in individuals, specifically recovering COVID-19 patients and healthy controls.

January 25, 2026Open Access

Head-to-head comparison of left ventricular strain assessed by CMR post-processing tools and fast Strain-ENCoded imaging

Key Result

In 240 individuals, LV global longitudinal strain showed moderate agreement between fSENC and post-processing methods, but values are not directly interchangeable (p<0.001).

Key Points

This research aims to compare left ventricular strain values assessed by different techniques in individuals, specifically recovering COVID-19 patients and healthy controls.
Analyzed 240 individuals including COVID-19 recovered patients and healthy controls
Utilized cardiovascular magnetic resonance (CMR) for imaging
Compared left ventricular global longitudinal, circumferential, and radial strain using feature tracking, tissue tracking, and fast Strain-ENCoded imaging
Evaluated reproducibility of different strain measurement techniques
Global strain values differed significantly across all methods (p<0.001)
High agreement between feature tracking and tissue tracking for global longitudinal strain with a bias of -0.8%
Moderate agreement found for circumferential strain with a bias of -1.2%
Poor agreement for radial strain with a bias of -6.0%
Post-COVID-19 patients showed a consistent but mild reduction in GLS compared to controls (all p<0.05)

Structured PICO

Are left ventricular strain values derived from CMR post-processing tools (FT, TT) directly comparable to those from fast Strain-ENCoded imaging (fSENC)?

Population

240 individuals (183 patients recovered from COVID-19 and 57 age- and sex-matched healthy controls)

Intervention

Left ventricular strain assessment using CMR post-processing tools (feature tracking [FT] and tissue tracking [TT])

Comparator

Left ventricular strain assessment using fast Strain-ENCoded imaging (fSENC)

Outcome

Agreement and comparability of left ventricular global longitudinal (GLS), circumferential (GCS), and radial strain (GRS) valuessurrogate

CMR strain values derived from different post-processing methods and dedicated sequences are not directly interchangeable, highlighting the need for method-specific reference values.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

Abstract Aims Cardiovascular magnetic resonance (CMR) strain imaging allows early detection of subclinical myocardial dysfunction and provides incremental diagnostic and prognostic information. Strain can be derived from dedicated sequences such as fast Strain-ENCoded imaging (fSENC) or from post-processing of cine images using feature tracking (FT) and tissue tracking (TT). However, it remains unclear whether strain values from different approaches are directly comparable, making the definition of universal reference values difficult. This study compared left ventricular (LV) strain assessed by FT, TT, and fSENC. Methods We studied 240 individuals (183 patients recovered from COVID-19 and 57 age- and sex-matched healthy controls), who underwent standardized CMR including cine imaging and fSENC. LV global longitudinal (GLS), circumferential (GCS), and radial strain (GRS) were analyzed using FT and TT; fSENC provided GLS and GCS. Results Global strain values differed significantly between all methods (p0.001). Agreement between FT and TT was high for GLS (bias -0.8%, r=0.77) and moderate for GCS (bias -1.2%, r=0.63), but poor for GRS (bias -6.0%, r=0.37). Compared with fSENC, GLS showed moderate agreement for FT (bias 2.3%, r=0.57) and TT (bias 3.0%, r=0.59), while agreement for GCS was weaker. All approaches demonstrated excellent reproducibility. Post-COVID-19 patients showed a consistent but mild reduction in GLS compared with controls across all techniques (all p0.05). Conclusion CMR strain imaging provides fast, reliable, and reproducible measurements. However, strain values are not directly interchangeable even between similar post-processing methods or when compared to dedicated sequences, highlighting the need for standardization and method-specific reference values.

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