Echocardiography in the assessment of left ventricular longitudinal systolic function: current methodology and clinical applications

Quantification of left ventricular (LV) systolic function represents a major aspect of echocardiographic assessment in the spectrum of cardiac diseases. However, because of the high complexity of LV contraction mechanics, the classical approach with assessment of a single measure of systolic function, such as ejection fraction or fractional shortening, has been largely superseded. During the last years, through the considerable technical advances in the field of ultrasonography, a number of different echocardiographic methodologies have become available to perform a detailed assessment of different aspects of LV contraction. In particular, evaluation of LV longitudinal systolic dynamics has progressively gained importance as a key aspect in the assessment of LV systolic function. For most of the techniques currently used to explore LV longitudinal function, the clinical usefulness in both research and daily practice has been validated by consistent evidence and their use is rapidly increasing. Technical considerations and potential clinical applications of the assessment of LV longitudinal systolic function are reviewed.