Role of Strain Imaging in Ischemic Heart Disease

The potential utility of strain imaging as a tool for quantitative assessment of myocardial contractile function has already been demonstrated in many cardiac conditions. Numerous studies have explored its utility in patients with coronary artery disease (CAD) also. Almost the entire spectrum of CAD has been studied and several different strain parameters and indices derived from global or regional longitudinal, circumferential, radial and area strain as well as left ventricular rotation have been employed. These studies have mostly shown that strain imaging can have an incremental role in the diagnosis and prognosis assessment of CAD. However, a few important limitations are there. Most importantly, CAD involves the left ventricle in a segmental manner and unfortunately, segmental strain at present has significant measurement variability rendering it unsuitable for routine clinical use. Nevertheless, strain imaging has many potential uses in CAD. This review describes the current understanding about the role of strain imaging in the evaluation and management of CAD.