A new study has reported that long-axis strain (LAS) (monoplanar and biplanar) may be a better marker of systolic dysfunction than left ventricular ejection fraction (LVEF) in patients with sickle cell disease (SCD).

The study, published in the Journal of Magnetic Resonance Imaging, also found that biplanar LAS was more precise than monoplanar LAS and that diagnostic accuracy was improved by normalizing the results to patient age.

“As SCD patients commonly demonstrate preserved LVEF, recent studies have questioned the role of this parameter as an early indicator of systolic dysfunction,” the authors wrote. “Thus, the aim of this study was to evaluate the diagnostic performance of rapidly assessed LAS as a measure of systolic impairment in patients with SCD compared to a healthy control group.”

The research team conducted a retrospective analysis of magnetic resonance imaging (MRI) data from 20 patients with SCD between 2007 and 2022. A healthy cohort of 39 participants served as the control group. Another 124 patients were included to validate the LAS method, and global longitudinal strain (GLS) was assessed in a prior study on 124 patients. Biplanar LAS was also assessed in this patient group for comparison.

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The results revealed that biplanar LAS was highly accurate in indicating systolic dysfunction in patients with SCD, and its ease of use and rapid results could represent a better approach than LVEF assessment for these patients.

Unlike with LVEF, age had a significant effect on LAS. Furthermore, biplanar LAS offered more precise measurements and, when normalized to age, improved diagnostic accuracy. However, the authors cautioned that the patient cohort was small.

The authors noted that LAS requires no additional MRI protocols and no dedicated software, and the results can be retrieved online in as little as 1 minute.


Grützediek K, Fischer R, Kurio G, et al. Rapid MRI assessment of long-axis strain to indicate systolic dysfunction in patients with sickle cell disease. J Magn Reson Imaging. Published online February 15, 2023. doi.10.1002/jmri.28623