Integrative Assessment of Left Ventricular Myocardial Work: Prognostic Utility and Clinical Application Across Cardiovascular Pathologies

Left ventricular myocardial work (MW) has emerged as a valuable echocardiographic parameter for evaluating cardiac function and predicting clinical outcomes. Unlike conventional indices such as left ventricular ejection fraction and global longitudinal strain, MW integrates myocardial deformation with left ventricular pressure, providing a load-adjusted and physiologically meaningful assessment of myocardial performance. Growing evidence demonstrates that impaired MW is consistently associated with adverse outcomes, including heart failure hospitalization, mortality, and functional deterioration, across a wide spectrum of cardiovascular conditions such as ischemic heart disease, valvular heart disease, and cardiomyopathies. The noninvasive estimation of MW using commercially available echocardiographic software has enhanced its feasibility in routine clinical practice, enabling improved risk stratification and early identification of high-risk patients. This review summarizes current evidence supporting the prognostic value of MW, highlights its incremental role beyond conventional echocardiographic parameters, and discusses future perspectives for its integration into everyday clinical decision-making.