Myocardial Work During Isometric Exercise: From Physiology to Clinical Practice

Assessment of left ventricular function by echocardiography has advanced remarkably in its ability to characterize aspects that extend beyond traditional measures of volume and ejection fraction (EF). Among these advances, the evaluation of contractility through two-dimensional strain analysis has gained particular prominence. Technological developments now allow this measure to be adjusted for afterload through myocardial work (MW), providing greater potential to identify subtle changes in ventricular function.

Isometric exercise represents a strategy to increase afterload through handgrip, proving particularly useful in echocardiography because it enables the identification of functional changes in different clinical settings, including coronary artery disease, assessment of diastolic function, hypertension, athletes, and even atrial functional mitral regurgitation.^–

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