Global longitudinal strain ( GLS) : Fine-tuning your 2D echo

Heart pumping i.e. left ventricular ejection fraction (LVEF) ( function of heart muscle) is considered an important predictor of long-term outcomes in a variety of problems. However, recent scientific advances have shown a new insight that LVEF is affected later in course of the disease. Global longitudinal strain is more sensitive than ejection fraction and it can detect changes in heart muscle at a very early stage. Even if the ejection fraction is normal, abnormal GLS signifies advanced disease.

How GLS is done:

GLS is a type of advanced echocardiography where imaging of heart muscle is done in a more precise manner. It quantifies the shortening of every segment of the left ventricular muscle. Integrating all segments, a bull’s eye image is created as shown below. It gives local as well as global longitudinal stains.

A disease where GLS can be useful:

• Heart failure with preserved ejection fraction: Elderly with diabetes and hypertension have this condition.
  
• Post Covid myocarditis – Inflammation and damage of heart muscle cells by Covid-19 viral infection.
• Ischemic heart disease in a stable person 
  
• Left ventricular hypertrophy: Athlete’s heart, hypertension, hypertrophic cardiomyopathy, amyloidosis
• Dilated cardiomyopathy
• Unstable angina: ( A type of heart attack) for early diagnosis
• Valvular heart disease: severe aortic stenosis/ aortic regurgitation, mitral regurgitation, etc
• Cardiac amyloidosis
• Myocarditis: inflammation of the heart
• Systemic inflammation: systemic sclerosis,
• Post-cancer chemotherapy: Chemotherapeutic agents have an adverse effect on cardiac function. GLS is a well-established marker in this condition.

GLS Can Predict heart failure in stable person