CPD Questions (Non-Invasive Myocardial Work)

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1. What is a key limitation shared by left ventricular ejection fraction (LVEF) and global longitudinal strain (GLS)?:

A. They require the use of ultrasound-enhancing agents.B. They are only reliable in patients with sinus rhythm.C. They are influenced by loading conditions.D. They cannot assess left ventricular systolic function.E. They consistently overestimate myocardial contractility.

2. Which two measurements are integrated to calculate non-invasive myocardial work?:

A. LV EF and cardiac output.B. Stroke volume and heart rate.C. E/e’ and diastolic blood pressure.D. LV longitudinal strain and systolic blood pressure.E. LV longitudinal strain and mean arterial pressure.

3. When should blood pressure ideally by measured for non-invasive myocardial work analysis?:

A. Before the patient enters the examination room.B. Immediately after the echo study is completed.C. At the time the strain images are acquired.D. Five minutes after the patient stands.E. Only in the right arm before imaging begins.

4. What does the area enclosed by the left ventricular pressure-strain loop represent?:

A. Myocardial work.B. Myocardial strain.C. Stroke volume.D. Left ventricular ejection fraction.E. Cardiac output.

5. Between which cardiac valve events is myocardial work calculated?:

A. Mitral valve opening to aortic valve closure.B. Aortic valve opening to aortic valve closure.C. Mital valve closure to mitral valve opening.D. Tricuspid valve closure to tricuspid valve opening.E. Pulmonary valve opening to pulmonary valve closure.

6. Which myocardial work parameter represents useful work that contributes to effective left ventricular contraction?:

A. Global wasted work.B. Myocardial oxygen consumption.C. Global myocardial work index.D. Myocardial work efficiency.E. Global constructive work.

7. Which of the following is classified as wasted myocardial work?:

A. Myocardial shortening during systole.B. Myocardial lengthening during isovolumic relaxation.C. Myocardial lengthening during systole.D. Myocardial relaxation during early diastole.E. Isovolumic contraction without a change in strain.

8. A myocardial work efficiency of 96% most likely indicates::

A. Severe left ventricular systolic dysfunction.B. Marked mechanical dyssynchrony.C. Efficient ventricular contraction with minimal wasted work.D. Significant myocardial ischaemia.E. Advanced hypertensive heart disease.

9. Which historical concept formed the physiological basis for modern non-invasive myocardial work assessment?:

A. Suga’s pressure-volume area concept.B. The simplified Bernoulli equation.C. The Frank-Starling mechanism.D. Simpson’s Biplane method.E. Laplace’s Law

10. In which clinical situation should standard non-invasive myocardial work measurements be interpreted with particularly caution?:

A. Mild mitral regurgitation.B. Significant aortic stenosis or left ventricular outflow tract obstruction.C. Patent foramen ovale.D. Sinus bradycardia.E. Small pericardial effusion.

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