Right Ventricular Global Longitudinal Strain (RV-GLS) Calculator

Right Ventricular Global Longitudinal Strain (RV-GLS): Explanation and Clinical Context RV-GLS quantifies right ventricular systolic deformation along the longitudinal axis from an RV-focused apical four-chamber view using 2D speckle-tracking. Two reporting conventions exist: a 6-segment global value that includes free wall and septum (RV-GLS), and a 3-segment free-wall-only value (RVFWLS). Because septal motion is influenced by LV mechanics and ventricular interdependence, RVFWLS is often more sensitive to intrinsic RV systolic performance, while RV-GLS integrates biventricular coupling effects.

Normal strain is more negative (greater shortening). The original NORRE dataset established sex- and method-specific lower-limit-of-normal (LLN) values: approximately −20% for RV-GLS and around −23% for RVFWLS (slightly more negative in women). Outcome studies across heart failure and cardiopulmonary cohorts consistently show that less negative RV strain conveys higher risk; pragmatic cut-points around −15% for RV-GLS and −18% for RVFWLS have been associated with increased mortality or adverse events.

However, technical factors (frame rate, image quality, foreshortening), hemodynamic loading (pulmonary pressures, RV afterload), and vendor-specific tracking differences can shift measured values. Therefore, interpretation should triangulate strain with conventional RV indices (TAPSE, S', FAC, 3D RVEF), right-sided pressures, and the clinical syndrome rather than relying on a single metric.