The Utility of Myocardial Work in Clinical Practice.

Myocardial work (MW) is a novel technique used in advanced assessment of left ventricular (LV) function. In the past few years, this invasive measure has evolved to a more attainable noninvasive technique. MW has benefits over LV ejection fraction (EF) and global longitudinal strain (GLS) by speckle tracking echocardiography (STE) as it includes the afterload-dependent limitation and dynamic myocardial contraction in relationship to various loading conditions. In this article, the authors give a summary overview and discuss the additive value noninvasive myocardial work provides to LV systolic function assessment. We explore the evolution of invasive to noninvasive MW, examine how to acquire and measure, discuss normal reference values, examine its role in a multitude of cardiac conditions that have been investigated by current research, review a variety of clinical applications, and discuss potential limitations. Our goal is to allow the reader to see the benefits of this rapidly emerging application and be able to incorporate it into everyday practice.