5 key points
- Due to the patchy distribution in the myocardium, regional abnormal strain patterns and values are seen, not related to coronary artery territory and often multiple regions in the LV and/or RV are affected
- Reduced circumferential and longitudinal strain correspond to deleayed enhancement on CMR, radial strain remains normal.
- GLS is typically reduced in patients with cardiac involvement, even when LVEF is preserved and no delayed enhancement on CMR is seen
- A cut off value of minus 17.3% predicts all-cause mortality, heart failure hospitalization, device implantation, new arrhythmias, or future development of CS on advanced cardiac imaging modalities
- Possibly, reduced strain in segments where no delayed enhancement is seen on CMR could reflect areas with active disease without irreversible fibrosis.
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