Simultaneous 4-Chamber Strain

Analysis of myocardial deformation, or strain imaging, is becoming part of routine echocardiography. The most widely accepted parameter to date has been global longitudinal strain as a measure of global left ventricular (LV) function. Global longitudinal strain (LS) of the LV, in (negative) percent, is the average of the maximal shortening (in percent) in the apicobasal direction of each of 18 LV segments visualized in the 3 standard apical views. The strain curves are computed using speckle tracking to determine myocardial velocity in a region of interest from which local strain is derived. LS is defined as deformation (shortening or lengthening) along the midline of LV walls, that is, in an apico-basal direction, but following the curvature of the LV walls. Similarly, global left or right atrial or right ventricular LS can be obtained as average of segmental peak LS. Strain data are highly dependent on image quality and frame rate, as well as physiological parameters as blood pressure.