U.S. health care spending grew 4.6 percent in 2018, reaching $3.6 trillion or $11,172 per person. For comparison, Switzerland the country with the second highest healthcare expenditure in the Organization for Economic Cooperation and Development (OECD) spent $7,280 per person.

Left ventricular performance has traditionally been evaluated by calculating ejection fraction (LVEF), however, the estimation of this by two-dimensional echocardiogram is subject to several limitations. On the other hand, speckle-tracking echocardiography (STE) with global longitudinal deformation (GLS) is increasingly used to assess even subtle myocardial dysfunction, although it is a well-validated method for clinical utility in the assessment of cardiac diseases, it remains limited by its load dependency [1,2].