Insights into myocardial mechanics in normal and pathologic states using newer echocardiographic techniques

Assessment of myocardial mechanics has been an important research endeavor in echocardiography for many years. Advances in understanding cardiac motion, coupled with treatments that address derangements in myocardial mechanics, have suggested that clinical application of this research may benefit patients in the detection of subclinical disease, quantification of myocardial tissue dynamics, and tracking changes in disease progression or in response to therapies. Newer techniques developed over the past two decades may better address the complex mechanics of cardiac motion than standard anatomic and physiologic echocardiographic measurements. This review describes the mechanics underlying the complexities of myocardial motion and describes standard and novel ways to measure these mechanics, including three-dimensional echocardiography, tissue Doppler imaging, and speckle tracking. Current and future applications of these methods are discussed, along with limitations.