Global Longitudinal Strain Patterns in Myocardial Disease. Global longitudinal strain in hypertensive heart disease may show a nonspecific decrease in strain values in the setting of symmetric and concentric LV hypertrophy whereas, other myocardial diseases often reveal a characteristic strain pattern. In cardiac amyloidosis, there is often a global decrease in longitudinal strain values most notable in the basal and mid ventricular segments and relative preservation at the LV apex. Longitudinal strain values in HCM are characteristically lowest among myocardial segments with maximal hypertrophy. Longitudinal strain values in Fabry Disease are often decreased in a nonspecific pattern although some authors have identified a predilection for the posterolateral wall in small retrospective studies. HCM, Hypertrophic cardiomyopathy.