• Bernadette Brady, Gerard King, Ross T Murphy, and Declan Walsh.
• Academic Department of Palliative Medicine, Our Lady's Hospice & Care Services, Harold's Cross, D6W EV82, Dublin 6W, Ireland. bbrady@olh.ie.
• Ir J Med Sci. 2023 Aug 1; 192 (4): 164916561649-1656.

BackgroundMyocardial strain-change in myocardial fibre length over the cardiac cycle-is a measure of cardiac muscle function. It is obtained using conventional techniques such as echocardiography and magnetic resonance imaging, adding additional clinical information to augment the current techniques.MethodsA narrative review of the current relevant literature with respect to myocardial strain, with a focus on strain measured by echocardiography.ResultsMyocardial strain identifies global and regional abnormalities in myocardial function and differentiates types of cardiomyopathy. It is an earlier marker of myocardial disease than ejection fraction and is predictive of cardiovascular adverse events. Accurate measurement requires high-quality images and experienced practitioners.ConclusionThis review explains advantages and disadvantages of myocardial strain imaging and explains why, through adding increased precision without additional burden, it should be a standard part of cardiac assessment.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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