Myocardial Strain Imaging

This policy addresses myocardial strain imaging—primarily speckle‑tracking echocardiography (with MRI and tissue Doppler techniques noted)—to quantify global longitudinal strain for detection and monitoring of subclinical left ventricular dysfunction and evaluation in populations such as patients with preserved LVEF, coronary/ischemic/valvular/dilated/hypertrophic cardiomyopathies, Takotsubo cardiomyopathy, and chemotherapy‑related cardiotoxicity. Major limitations/requirements: the policy deems strain imaging investigational/unproven for all indications, limits use to FDA‑cleared speckle‑tracking software as an adjunct to an indicated transthoracic echocardiogram (not a standalone screen), and cites substantial technical, standardization, and evidence‑quality deficits that require demonstration of clinical utility to change management.

"Use myocardial strain measurement to detect subclinical myocardial impairment before symptoms appear"