Clinical Report: Evaluating the Clinical Significance of Perioperative Myocardial Strain

Overview

This study evaluates the association of perioperative global longitudinal strain (GLS) measured via transesophageal echocardiography with postoperative myocardial injury in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Key findings indicate that GLS is significantly associated with biomarker-defined myocardial injury and early cardiac functional alterations.

Background

Postoperative myocardial injury is a significant concern following off-pump coronary artery bypass grafting (OPCABG), impacting patient outcomes. Traditional methods for assessing myocardial injury often fail to capture the full extent of myocardial function changes. The use of two-dimensional speckle tracking imaging (2D-STI) allows for a more accurate evaluation of myocardial deformation.

Data Highlights

Key Findings

• GLS values were significantly lower in the high-risk group compared to the low-risk group at all measured time points (T0, T1, T2).
• GLS showed negative correlation with 48-hour peak CK-MB, hs-cTnI, and BNP levels.
• GLS at T0, T1, and T2 were independently associated with biomarker-defined postoperative myocardial injury.
• Δ2 demonstrated a stronger predictive value for myocardial injury compared to Δ1.
• ROC analysis indicated that T0 GLS, T2 GLS, and Δ2 had predictive values with AUCs of 0.885, 0.884, and 0.840, respectively.

Clinical Implications

The findings indicate that perioperative GLS measurements are associated with myocardial function and risk assessment during OPCABG.

Conclusion

Perioperative GLS derived from transesophageal echocardiography is associated with postoperative myocardial injury.

Related Resources & Content

1. Frontiers in Cardiovascular Medicine, 2026 -- Multi-chamber three-dimensional myocardial strain assessment by computed tomography: a comparison with speckle tracking echocardiography and association with pulmonary hypertension in severe aortic stenosis
2. Clinical Research in Cardiology, 2017 -- Assessment of Longitudinal Strain via Cardiac Magnetic Resonance Relates to Hemodynamic Parameters in Severe Aortic Stenosis Patients and Forecasts Positive Remodeling Post-Transcatheter Aortic Valve Replacement
3. European Radiology, 2024 -- Assessment of Atrial and Ventricular Strain via Cardiovascular Magnetic Resonance for Predicting Outcomes in Patients with Pericarditis: A Preliminary Investigation
4. Clinical Research in Cardiology, 2025 -- Implications of Non-Invasive Myocardial Work Assessment in Patients Receiving Left Ventricular Assist Devices
5. Clinical Applications of Strain Echocardiography: A Clinical Consensus Statement From the American Society of Echocardiography Developed in Collaboration With the European Association of Cardiovascular Imaging of the European Society of Cardiology, 2025
6. Considerations of Intraoperative Transesophageal Echocardiography During Adult Cardiac Surgery - Professional Heart Daily | American Heart Association, 2025
7. Fourth Universal Definition of Myocardial Infarction (2018) | JACC
8. Clinical Applications of Strain Echocardiography: A Clinical Consensus Statement From the American Society of Echocardiography Developed in Collaboration With the European Association of Cardiovascular Imaging of the European Society of Cardiology
9. Considerations of Intraoperative Transesophageal Echocardiography During Adult Cardiac Surgery - Professional Heart Daily | American Heart Association
10. Fourth Universal Definition of Myocardial Infarction (2018) | JACC