GLS Clinical Applications — EECC MCQ
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Correct answer: C — GLS measures myocardial deformation (shortening) in the longitudinal plane; it detects subclinical systolic dysfunction before LVEF declines and is particularly valuable in cardio-oncology, HCM, amyloidosis, and aortic stenosis
Global longitudinal strain (GLS) measured by 2D speckle-tracking echocardiography quantifies myocardial deformation (percentage of shortening) in the longitudinal direction. Normal GLS is approximately -18% to -22% (more negative = better function). GLS detects subclinical systolic dysfunction before LVEF declines because longitudinal function (subendocardial fibres) is affected early, while LVEF is maintained by compensatory radial/circumferential function. Key clinical applications: (1) Cardio-oncology: GLS >15% relative reduction triggers consideration of cardioprotective therapy (Class I, ESC); (2) HCM: reduced GLS despite preserved LVEF predicts adverse outcomes; (3) Amyloidosis: characteristic 'cherry on top' pattern (apical sparing); (4) AS: subclinical LV dysfunction guiding intervention timing.
Reference: ASE/EACVI Strain Guidelines; ESC (2022): Cardio-Oncology Guidelines