Prognostic utility of global longitudinal strain in myocardial infarction

Cardiovascular magnetic resonance (CMR) represents the reference standard for cardiac morphology and function assessment. Since introduction in 2009, CMR feature tracking (CMR-FT) has become a frequently used tool in the assessment of myocardial deformation and wall motion on the basis of routinely acquired b-SSFP cine images. Extensive validation has led to excellent intra- and inter-observer as well as inter-study reproducibility. CMR-FT derived myocardial deformation indices such as left ventricular (LV) strain have been shown to be impaired in cardiac diseases such as cardiomyopathies as well as myocardial infarction. Although LV ejection fraction (LVEF) is the routinely and frequently utilized parameter for systolic myocardial function assessment and major adverse clinical event (MACE) prediction, it fails to assess regional differences. Recently, LV strain has emerged as a superior measure for risk assessment and MACE prediction as compared to the established markers e.g., LVEF. This editorial aims to elucidate current discussions in the field of strain assessment in myocardial infarction in the light of recent data from a large prospective multicentre CMR study.