JCMR 2020; 22:81. Layer-specific strain in patients with heart failure using cardiovascular magnetic resonance: not all layers are the same (CME)

Purpose/ Objective

Left ventricular strain is sensitive to systolic dysfunction, independent of ejection fraction, such as in those with heart failure with preserved ejection fraction (HFpEF). However, several distinct strain components are routinely measured, most commonly globally averaged longitudinal, circumferential and radial. However, global strains can be measured on the endocardium, epicardium or averaged across the wall thickness with large differences in normal/pathologic values at each location and with distinct performance in terms of identification of systolic dysfunction or outcomes prediction in heart failure.


What is the current state/problem in practice? Currently, left ventricular strains are not measured or reported with consideration of layer-dependence (endocardium to epicardium) of values. What is the ideal state/ if the problem is gone? Ideally, left ventricular strains would be reported with clear specification of measurement locations, and with the consideration of added value of layer-specific strains.


This CME activity will raise awareness of layer-dependence of left ventricular strains and the potential added value of consideration of layer-specific assessment.


Learning Objectives

1. Learners should be aware that distinct layer-specific left ventricular strains can be used measured for detection of systolic dysfunction.

2. Learners should be aware of the capabilities of their strain analysis software and should specify the locations of strain analysis (e.g. is global longitudinal strain (GLS) measured on the endocardial surface or the average of all locations over the wall thickness).


Accreditation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


Credit Designation Statement
The Society for Cardiovascular Magnetic Resonance (SCMR) designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Instructions for Claiming CME

  • Read and fully comprehend the article
  • Complete the post-activity evaluation
  • A certificate of completion will be available once the evaluation is submitted


Financial Disclosures

The planners and faculty for this activity did not have any relationships to disclose.


Disclosure of Commercial Support

This activity received no commercial support.


Please see the bibliography at the end of the journal article.

Course Information
Course Date:
January 08, 2021
Individual topic purchase: Selected
Accreditation Council For Continuing Medical Education
Total General Hours: 1.00
SCMR Member Price:$0.00
Non-Member Price:$10.00