After many years of intense clinical research, global longitudinal strain (GLS) has now established its value in the clinical practice of echocardiography, especially in the evaluation of subclinical cardiomyopathy. GLS has been shown to be more sensitive than traditional ejection fraction (EF) to detect early subclinical myocardial dysfunction, and both are considered standard parameters for left ventricular (LV) quantification in guideline recommendations. 1 Despite this, both EF and longitudinal strain are sensitive to changes in preload and afterload. 2 An increase in afterload has been shown to decrease the magnitude of strain, leading to misinterpretation of the true contractile function of the myocardium, and can lead to false conclusions with regard to reduced myocardial function. A meta-analysis of 24 studies showed that variations in the normal range of strain are affected by afterload because of differences in blood pressure (BP). 3 However, this load-dependent limitation of strain can be improved by measuring myocardial work, which considers both longitudinal strain and the afterload exerted on the left ventricle.