Abstract

Left ventricular (LV) dysfunction increases the risk for serious post-operative complications. Accurate assessment of LV wall motion is necessary to guide anesthetic management; however, traditional measures have a high degree of inter- and intra-observer variability. Myocardial deformation as measured by strain and strain rates is improving the diagnostic and prognostic utility of echocardiography to determine LV function in patients with cardiovascular disease. Strain can be measured using tissue Doppler and speckle tracking imaging from two-dimensional or three-dimensional echocardiography using various online and offline software packages. Tissue Doppler strain analysis provides excellent temporal resolution but is limited by the imaging angle of insonation. Speckle tracking strain imaging is angle independent and now the more commonly used modality. Strain has been demonstrated to guide therapy, monitor disease progression in various pathologic states, and is emerging as a strong predictor of clinical outcomes.

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