https://orcid.org/0000-0002-5241-2758
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Pablo Martínez-Legazpi, Candelas Pérez del Villar, Javier Bermejo, Regional myocardial mechanics: there’s more than meets the strain, European Heart Journal - Cardiovascular Imaging, Volume 21, Issue 6, June 2020, Pages 629–631, https://doi.org/10.1093/ehjci/jeaa055
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This editorial refers to ‘Acute redistribution of regional left ventricular work by cardiac resynchronization therapy determines long-term remodelling’, by J. Duchenne et al., pp. 619–628.
In the present issue of the Journal, Duchenne et al.1 present the results of a multicentric study relating the response to cardiac resynchronization therapy (CRT) to the homogenization of ventricular myocardial work achieved acutely by the device. The study is an encouraging example of the potential of academically developed technologies designed to complement more established methods provided by the imaging industry.
Assessment of left ventricular regional mechanics has been of paramount interest for clinicians and researchers since the beginnings of cardiac imaging. For decades, eyeball assessment of wall motion has been the cornerstone method for addressing regional ventricular function and, in good hands, still has priceless value in modern cardiovascular medicine.2
In the late 90s, post-processing developments enabled obtaining indices of myocardial deformation previously reserved to invasive sonomicrometric experiments or complex tagging magnetic resonance sequences. This opportunity for measuring myocardial strain opened a whole new world in the analysis of cardiac function. In continuum mechanics, strain accounts for the relative deformation of a body. Current methods for measuring myocardial strain, are based on tracking image features along the cardiac cycle at high temporal and spatial resolutions.3,4 Early adopted by most ultrasound vendors, strain soon became the basis of hundreds of studies flooding the imaging literature. The clinical potential of strain to detect subtle myocardial abnormalities in almost all cardiac diseases previously known5 or unknown6 to impact regional function is only beginning to be exploited.3 However, the fact that strain shows only a partial picture of regional mechanics should not be overlooked.
