From the Guidelines
The method for obtaining global longitudinal strain (GLS) via echocardiogram is through automated speckle tracking echocardiography, which is an emerging technique for detecting and quantifying subtle disturbances in left ventricular (LV) systolic function 1.
Normal Value of GLS
The normal value of GLS in a 66-year-old female post-chemotherapy and radiation treatment is not explicitly stated in the provided evidence, but a GLS value of >19% is generally considered normal, while a value of <19% is predictive of subsequent cardiotoxicity 1.
Key Points
- GLS reflects the longitudinal contraction of the myocardium and its accuracy has been validated against tagged magnetic resonance imaging 1.
- A GLS reduction of <8% from baseline is not meaningful**, but **>15% from baseline is very likely abnormal 1.
- GLS is the most sensitive and specific measurement for the early detection of subclinical myocardial injury 1.
- A 10% to 15% early reduction in GLS during therapy appears to be the most useful parameter for the prediction of cardiotoxicity 1.
- There is currently no evidence to guide specific cardioprotection if early signs of subclinical myocardial dysfunction are detected during echocardiography-based GLS surveillance, and cancer treatment should not be stopped, interrupted, or reduced in dose based on a new GLS reduction alone 1.
From the Research
Method for Obtaining Global Longitudinal Strain via Echocardiogram
- The method for obtaining global longitudinal strain (GLS) via echocardiogram involves using speckle-tracking analysis of 2-dimensional echocardiography 2, 3.
- This method measures myocardial deformation and provides a more sensitive assessment of left ventricular function compared to traditional ejection fraction measurements 2, 3.
- A new method for measuring GLS using a logarithmic-transform correlation (LTC) method has also been developed, which is automated and does not require cardiac chamber segmentation and regularization 4.
Normal Value of Global Longitudinal Strain in a 66-year-old Female Post-Chemotherapy and Radiation Treatment
- The normal range of left ventricular global longitudinal strain (GLS) has been defined as -18% and lower (i.e., more negative), with abnormal values being -16% or higher (i.e., less negative) 2.
- A relative reduction in GLS of >15% from baseline has been used to detect cardiotoxicity in patients undergoing chemotherapy 5.
- However, the normal value of GLS in a 66-year-old female post-chemotherapy and radiation treatment may vary depending on individual factors, such as the type and dose of chemotherapy, radiation treatment, and underlying cardiac function 5, 6.
- It is essential to consider the image quality of the echocardiogram, as suboptimal image quality can affect the accuracy of GLS measurements 6.