Key result
Non-invasive pressure-strain myocardial work correlates well with invasive measurements for load-independent LV assessment.
Why the study?
Standard echocardiographic parameters do not account for LV pressure, and the incremental prognostic validity of non-invasive pressure-strain analysis compared to common echocardiographic parameters remains unclear.
Non-invasive myocardial work assessment via pressure-strain analysis is a promising echocardiographic tool that provides load-independent insights into cardiac mechanics and energetics across various cardiac pathologies.
May aid load-independent LV assessment clinically; leaves open incremental prognostic value over standard echocardiography.
Pressure-volume (PV) analysis is the most comprehensive way to describe cardiac function, giving insights into cardiac mechanics and energetics. However, PV analysis still remains a highly invasive and time-consuming method, preventing it from integration into clinical practice. Most of the echocardiographic parameters currently used in the clinical routine to characterize left ventricular (LV) systolic function, such as LV ejection fraction and LV global longitudinal strain, do not take the pressure developed within the LV into account and therefore fall too short in describing LV function as a hydraulic pump. Recently, LV pressure-strain analysis has been introduced as a new technique to assess myocardial work in a non-invasive fashion. This new method showed new insights in comparison to invasive measurements and was validated in different cardiac pathologies, e.g., for the detection of coronary artery disease, cardiac resynchronization therapy (CRT)-response prediction, and different forms of heart failure. Non-invasively assessed myocardial work may play a major role in guiding therapies and estimating prognosis. However, its incremental prognostic validity in comparison to common echocardiographic parameters remains unclear. This review aims to provide an overview of pressure-strain analysis, including its current application in the clinical arena, as well as potential fields of exploitation.
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Abawi et al. (2021) conducted a review in Cardiac pathologies (Heart failure, Ischemic heart disease, CRT candidates). Non-invasive assessment of myocardial work by pressure-strain analysis was evaluated. Non-invasive assessment of myocardial work by pressure-strain analysis provides a load-independent evaluation of left ventricular function that correlates well with invasive measurements.
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