Advancing Strain Imaging: ASE/EACVI Guidelines Overview
Publication Title: Delivering on Past Promise: The ASE/EACVI Clinical Applications of Strain Echocardiography Consensus Statement
Summary
- Question
- This paper outlines the key advancements and clinical applications of strain echocardiography, specifically global longitudinal strain (GLS), as described in the 2025 consensus statement jointly published by the American Society of Echocardiography (ASE) and the European Association of Cardiovascular Imaging (EACVI). The study aimed to standardize strain imaging practices and establish guidelines for its clinical use in assessing heart function and predicting outcomes.
- Why it Matters
- Strain echocardiography is a non-invasive imaging technique used to assess heart muscle function by measuring its deformation during contraction. This method has shown strong prognostic value, particularly in heart failure, valvular disease, and other cardiac conditions. The updated guidelines address past challenges, such as variability in measurements, and provide a roadmap for integrating strain imaging into clinical practice. These advancements hold promise for improving diagnosis, monitoring, and treatment strategies, benefiting patients and guiding healthcare providers in decision-making.
- Methods
- The consensus statement was developed by analyzing observational studies, clinical evidence, and expert opinions. It focused on strain imaging's use in various cardiac conditions, including heart failure, ischemic and non-ischemic heart disease, valvular disease, and atrial and ventricular function. The paper also reviewed technical considerations, standardization efforts, and gaps in current knowledge to create practical recommendations for clinicians.
- Key Findings
- The authors identified global longitudinal strain (GLS) as a robust predictor of cardiac outcomes, often superior to traditional measures like left ventricular ejection fraction (LVEF). They defined normal GLS as more negative than -18%, with values less negative than -16% considered abnormal. Right ventricular strain and left atrial strain were also validated as useful metrics for assessing specific cardiac conditions. The consensus highlighted improved standardization across imaging platforms but noted some remaining variability. Additionally, the utility of strain imaging in perioperative and dynamic settings, such as surgery, remains underexplored.
- Implications
- The findings support the broader adoption of strain echocardiography in clinical settings, offering enhanced diagnostic and prognostic capabilities. GLS can provide insights into heart function not captured by traditional metrics like LVEF, aiding in early intervention and treatment planning. Standardized guidelines will help clinicians apply strain imaging more consistently, potentially improving patient outcomes in heart failure, valvular disease, and other conditions.
- Next Steps
- The authors emphasized the need for further research to refine strain imaging techniques, especially in dynamic and perioperative contexts. They also called for studies exploring its application in underexamined areas like atrial physiology and diastology. Additionally, they recommended efforts to promote clinical adoption and evaluate strain imaging's integration into future guidelines.
- Funding Information
Yale University provided funding and support for this research.
Full Citation
Insler J, Shears M, Notarianni A. Delivering on Past Promise: The ASE/EACVI Clinical Applications of Strain Echocardiography Consensus Statement. Journal Of Cardiothoracic And Vascular Anesthesia 2026 DOI: 10.1053/j.jvca.2026.03.028.
This AI-assisted summary has been reviewed and approved by at least one of the study's authors to ensure it accurately reflects the research.
Authors
Joshua Insler
First AuthorAndrew Philip Notarianni, MD, FASE, FASA
Last AuthorAssistant Professor of Anesthesiology