From the Research
An abnormal left ventricular (LV) strain of -15% indicates mild to moderate impairment of left ventricular contractile function, suggesting that the heart muscle is not contracting as efficiently as it should, though it is not severely compromised. This value is less negative than the normal range, which is typically more negative than -18% to -20%, with less negative values indicating worse function 1. The finding of an abnormal LV strain of -15% warrants further cardiac evaluation, including a comprehensive echocardiogram, assessment of ejection fraction, and possibly other cardiac imaging, to determine the underlying cause of the impaired contractile function. Some possible causes of this impairment include coronary artery disease, hypertension, cardiomyopathy, or valvular heart disease. Management of this condition depends on the underlying etiology, but may include medications like ACE inhibitors, beta-blockers, or ARBs to prevent further cardiac remodeling, as well as lifestyle modifications such as sodium restriction, regular exercise as tolerated, and smoking cessation 2, 3. It is essential to note that this strain abnormality reflects reduced myocardial deformation during contraction and often precedes reductions in ejection fraction, making it a sensitive early marker of cardiac dysfunction. In the context of heart failure with preserved ejection fraction (HFpEF), impaired LV global longitudinal strain (GLS) is common, indicating the presence of covert systolic dysfunction despite normal LV ejection fraction 3. Overall, the management of an abnormal LV strain of -15% should prioritize reducing morbidity, mortality, and improving quality of life, and should be guided by the most recent and highest quality evidence available 1.
Some key points to consider in the management of this condition include:
- The importance of early detection and treatment of underlying causes of impaired contractile function
- The role of medications such as ACE inhibitors, beta-blockers, and ARBs in preventing further cardiac remodeling
- The need for lifestyle modifications, including sodium restriction, regular exercise, and smoking cessation
- The importance of regular monitoring and follow-up to assess the effectiveness of treatment and to detect any changes in cardiac function. It is crucial to consider the most recent and highest quality evidence available when making treatment decisions, and to prioritize reducing morbidity, mortality, and improving quality of life 1.