# Myocardial Work by Echocardiography: Principles and Applications in Clinical Practice

## TL;DR

This paper reviews a new echocardiographic method called myocardial work that improves the assessment of heart function beyond traditional measures.

## Contribution

The paper introduces non-invasive myocardial work quantification as a loading-independent alternative to assess myocardial function.

## Key findings

- Myocardial work overcomes limitations of global longitudinal strain and ejection fraction.
- Commercial echocardiographic software enables practical application of myocardial work assessment.
- Myocardial work provides a more accurate evaluation of heart function in clinical settings.

## Abstract

Left ventricular (LV) global longitudinal strain (GLS) has established itself in the last decade as a reliable, more objective method for the evaluation of LV systolic function, able to detect subtle abnormalities in LV contraction even in the presence of preserved ejection fraction (EF). However, recent studies have demonstrated that GLS, similar to LV EF, has important load dependency. Non-invasive myocardial work (MW) quantification has emerged in the last years as an alternative tool for myocardial function assessment. This new method, incorporating measurement of strain and LV pressure, has shown to overcome GLS and LV EF limitations and provide a loading-independent evaluation of myocardial performance. The presence of a commercially available echocardiographic software for the non-invasive MW calculation has allowed the application of this new method in different settings. This review sought to provide an overview on the current knowledge of non-invasive MW estimation, showing its potential applications and possible added value in clinical practice.