CPD Questions (Back-to-Basics: LV Strain Imaging)

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1. Which of the following best defines strain in engineering and echocardiography terms?:

A. The force applied to a material to cause it to move.B. The percentage change in length of a material relative to its original length.C. The absolute velocity of a tissue segment moving through space.D. The volume change of a cardiac chamber during a single cardiac cycle.

2. In systolic longitudinal strain imaging, what does a negative value represent?:

A. Myocardial thickening.B. Myocardial lengthening.C. Myocardial shortening.D. Myocardial relaxation.

3. Why is speckle tracking generally preferred over Tissue Doppler Imaging (TDI) for strain analysis?:

A. TDI requires 3D image acquisition.B. TDI is highly angle-dependent, while speckle tracking is angle-independent.C. Speckle tracking does not require a high frame rate.D. Speckle tracking performs better on 2D images.

4. Myocardial strain is considered a vector because it contains which two components?:

A. Length and width.B. Acceleration and speed.C. Magnitude and direction.D. Pressure and volume.

5. Which LV myocardial layer contains the predominant longitudinal fibres, making longitudinal strain highly sensitive to early dysfunction?:

A. Epicardium.B. Mid-myocardium.C. Subendocardium.D. Pericardium.

6. Which of the following statements regarding Left Ventricular Ejection Fraction (LVEF) and Global Longitudinal Strain (GLS) is true?:

A. LVEF always drops before a reduction in GLS is detected.B. GLS may be reduced even if LVEF remains normal.C. LVEF and GLS provide identical information about myocardial deformation.D. GLS is only useful when LVEF is below 35%.

7. In a Bulls eye plot of a normal left ventricle, what colour should the segments predominantly be during systole?:

A. Bright blue.B. Uniformly red.C. Multicolored (rainbow).D. Pale pink and white.

8. Apical Sparing on a GLS Bulls eye plot is a characteristic pattern for which cardiac condition?:

A. Septal myocardial infarction.B. Apical hypertrophic cardiomyopathy.C. Cardiac amyloidosis.D. Severe aortic stenosis.

9. What is mechanical dispersion (MD) used to measure in strain imaging?:

A. The average myocardial shortening during ventricular systole.B. The time difference (standard deviation) to peak longitudinal strain between LV segments.C. The total myocardial shortening dispersed during ventricular systole.D. The degree of epicardial dispersion throughout the cardiac cycle.

10. What is the recommended minimum number of studies a trainee should perform to achieve expert competency in LV GLS analysis?:

A. 10 studies.B. 25 studies.C. 50 studies.D. 100 studies.

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