VALVULAR HEART DISEASE: Edited by Subodh Verma and Bobby YanagawaClinical application of echocardiographic-derived myocardial strain imaging in subclinical disease a primer for cardiologistsOng, Géraldine; Yan, Andrew T.; Connelly, Kim A.Author Information Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada Correspondence to Géraldine Ong, MD, MSc, Division of Cardiology, St. Michael's Hospital, 30 Bond St., Toronto, ON M5B 1W8, Canada. Tel: +416-864-5376; fax: +416-864-6021; e-mail: firstname.lastname@example.org Current Opinion in Cardiology: March 2019 - Volume 34 - Issue 2 - p 147-155 doi: 10.1097/HCO.0000000000000592 Buy Metrics Abstract Propose of review To highlight the evidence to support the measurement of left ventricular (LV) global longitudinal strain (GLS) in the risk assessment and management of patients with valvular heart disease. Recent findings Subclinical myocardial dysfunction that is characterized by impaired LV GLS is often present in patients with valvular disease. The addition of GLS to the LV systolic function assessment refines disease classification and improves both prognosis and management of valvular disease. Summary The measurement of global systolic function is essential in risk assessment and management of all patients with valvular heart disease. Although LV ejection fraction remains the main parameter of systolic function, strain measurement has emerged as a promising systolic function marker. Strain describes deformation of the myocardium that occurs during the cardiac cycle in the longitudinal, circumferential, and radial planes. Of all the regional strain deformation measurements, evidence gathered over the last decade has shown that GLS improves detection of systolic dysfunction beyond LV ejection fraction and provides additional prognostic information. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.