Shiino K, et al. - Using multi-layer global longitudinal strain (GLS) by 2D speckle-tracking echocardiography (STE), researchers studied the impacts of transcatheter aortic valve implantation (TAVI), an effective therapeutic option for severe symptomatic aortic valve stenosis (AS) with intermediate or high surgical risk, on left ventricular (LV) mechanics. Study participants included 119 patients with severe symptomatic AS and normal LV ejection fraction (LVEF) who underwent echocardiography at baseline and 1-month post-TAVI. In patients with severe AS, multi-layer GLS is more sensitive than conventional LVEF to detect the early improvement in LV systolic function after TAVI. A disproportional improvement was noted in different layers with the least improvement in the endocardium. They suggested that multi-layer strain analysis can give new insights into the understanding of AS mechanics.