Strain Measurement Activity

From this learning activity you will:

  1. Have access to echocardiography images in patients receiving cancer therapy to measure global longitudinal strain (GLS).
  2. Be able to analyze the cases and send it back for expert review and feedback (personalized).
  3. Have the ability to compare your diagnosis of cardiotoxicity based on an external reference standard and clinical information.
  4. Use the personalized feedback to analyze a second set of cases to assess improvement in accuracy.

This activity has been made available for informational and educational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.


Please read the following documents prior to beginning the learning activity:

  1. Strain Image Selection and Post-Processing Examples
  2. Negishi et al., 2015. Practical Guidance in Echocardiographic Assessment of Global Longitudinal Strain. JACC.
    1. For EchoInsight: a step-by-step guide for analyzing strain will be provided from Epsilon once you have signed up with EchoInsight.
    2. For GE, Philips and Tomtec: please watch Supplemental Videos 1, 6, 10, 12, 13 at the link below which provide step-by-step instructions as to how to analyze strain this software:


Once you have completed Step 1, please fill out the form below.


  • Some of the cases were diagnosed with cardiotoxicity while others were not.
  • Two relevant time points during cancer therapy were chosen. These time points will be discussed during feedback.
  • Please follow the instructions very carefully.

If you have any questions, please email our team at

Strain Case Study Download Form

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* EchoInsight software and cases are available online, no download required.
GE cases will require the use of participants’ local strain analysis software.