Hypertrabeculation
GLS -15,4% as a cut-off for pathological hypertrabeculation (with heart failure) in normal EF
Sarcoid heart disease
Strain shows subclinical involvement for sarcoid heart disease (cut-off GLS -16%; FWS -19,9%)
Worse prognosis from GLS >-17,3% & FWS >-20%; LA Strain often reduced (sequence ➜ LV-problem, elevated LA pressures, elevated sPAP ➜ PHT is a marker for bad prognosis)
Diagnostic algorithm ➜ in extracardiac sarcoidosis:
a) normal EF & EKG ➜ GLS>-16,3% or FWS >-19,9% ➜ MRI or myocardial biopsy could be necessary (endomyocardial biopsy is diagnostic)
b) reduced EF, BBB-contraction, VT ➜ exclude CAD ➜ MRI, PET-CT & myocardial biopsy could be necessary (endomyocardial biopsy is diagnostic)
ARVC & ACM
Strain reduction in the involved areas
FWS more positive than -20% as a predictor for progressing structural change
LV-GLS more positive than -12,6% as a cut-off for worse outcome. LV-GLS is also significantly reduced in normal EF
Cut-off for RV GS -18% — signs of structural tissue change (fibrosis, fatty replacement)
Constrictive pericarditis
In constriction strain reversus (medial > lateral) & hot septum (hyperdynamic strain), septal bounce & shift in strain
Ebstein’s anomaly
RV GS more positive than -18% (FWS >-20%) as an independent prognostic parameter in Ebstein's anomaly
