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Global Longitudinal Strain — EECC MCQ

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ModerateCardiac ImagingGlobal Longitudinal StrainEECC

A 58-year-old woman with HFrEF (LVEF 38%) undergoes echocardiography with speckle tracking. Her global longitudinal strain (GLS) is -12%. What is the clinical significance of this finding?

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Correct answer: E — GLS is more impaired than expected for her LVEF and identifies subclinical myocardial dysfunction with additional prognostic value beyond LVEF

Global longitudinal strain (GLS) provides incremental prognostic information beyond LVEF in heart failure. Normal GLS is approximately -18% to -22% (more negative = better function). A GLS of -12% is significantly impaired and indicates worse prognosis than would be predicted by LVEF alone. GLS detects subclinical myocardial dysfunction earlier than LVEF and is less load-dependent. The ESC HF and Imaging Guidelines recognise GLS as a prognostic marker across the HF spectrum. In HFpEF, impaired GLS (less negative than -16%) is particularly useful for identifying patients at risk of adverse outcomes despite preserved LVEF. GLS is also used to monitor cardiotoxicity during chemotherapy.

Reference: ESC/EACVI Recommendations on Cardiac Imaging in Heart Failure