Myocardial work – are we ready for a new parameter in clinical practice for evaluating left ventricle function?

Left ventricle systolic function is an essential parameter in different clinical scenarios and the usual methods available for its assessment are sometime suboptimal, depending on the filling conditions of the heart. Therefore, the development and implementation in clinical practice of a new parameter for assessing left ventricle contractile function is desirable. Mechanical work defined as energy transferred to or from an object via the application of force along a displacement seems to be a promising method for myocardial performance estimation. Although initially this parameter was calculated on the left ventricle volume-pressure curve estimated by cardiac catheterization, an easier method considering non-invasive left ventricle pressure and global longitudinal strain assessed by speckle tracking echocardiography was developed recently. Myocardial work offers information regarding the segmental and global function of the left ventricle, and it is considered a more sensitive marker for assessing left ventricle performance compared to ejection fraction and global longitudinal strain. Its applicability in various cardiac pathologies was demonstrated recently in several studies and its use in every day practice may bring important additional information for clinical decision making.