LAUSR

SEE PAGE 1947 C ardiac function is a powerful prognostic marker. A great number of clinical decisions are based on the performance of the left ventricle, such as medication for heart failure (HF), primary prevention implantable cardiac defibrillator treatment, and timing of valve interventions, among others. The method for assessing left ventricular function has long been synonymous with the left ventricular ejection fraction (EF), a term with >70,000 hits on PubMed. Other methods to evaluate left ventricular function were introduced during the past years, but were most often discarded. Myocardial strain imaging was introduced in the 1990s and this method has persisted, although its path to acceptance by the medical community has been thorny (1,2). Global longitudinal strain (GLS) has emerged as a fine-tuned, highly reproducible, and operatorfriendly method for quantification of left ventricular function and prognostication in a wide spectrum of cardiac diseases (3). Long ago accepted in the cardiac imaging research community and headlining numerous conferences over the last decade, the way toward guideline implementation of GLS moves slowly ahead. Skepticism against the specifics of the underlying technology (vendor secrecy) and potential vendor differences is legitimate (4), but seems to overshadow the growing pile of evidence for the clinical use and added value of GLS beyond EF.