Assessment of Myocardial Fibrosis by Myocardial Deformation Analysis via Echocardiography

Abstract

Myocardial fibrosis (MF) is a pathological condition common to several primary and secondary heart diseases. Diffuse MF is a common feature in nearly all heart diseases, playing a crucial role in the progression of heart failure (HF). Several studies have indicated that the existence of MF serves as a prognostic factor for adverse outcomes across a range of heart conditions, underscoring the significance of this factor in clinical settings. Consequently, diagnostic approaches for MF, whether in subclinical phases or within established heart diseases, emerge as valuable instruments for early detection, risk stratification, and/or ongoing monitoring of disease developments. Despite being the most accurate non-invasive test for MF research, cardiovascular magnetic resonance (CMR) imaging is a test that is not widely available and is expensive. An alternative method with increased accessibility and cost-effectiveness for assessing heart diseases and researching MF involves echocardiography with the Speckle Tracking (STE) technique to evaluate myocardial deformation (“strain”). Studies show that diminished strain values (both global and segmental) in various heart conditions are associated with the presence and extent of MF, as determined by CMR or histological analysis. MF research using echocardiographic myocardial deformation analysis with STE has gained more space in clinical and research routines as it is an easy-to-perform and low-cost test. The results found by this technique can have a relevant diagnostic, therapeutic, and prognostic impact on clinical practice.