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Related Experiment Video

Updated: Jan 21, 2026

Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
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How Does Regional Hypertrophy Affect Strain Measurements With Different Speckle-Tracking Methods?

Monica Dobrovie1, Stėphanie Bėzy2, Serkan Ünlü3

  • 1Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium; Department of Cardiology, Institute of Emergency for Cardiovascular Diseases "Prof. Dr. C.C. Iliescu", Bucharest, Romania.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|August 5, 2019
PubMed
Summary

Abnormal heart shapes like septal bulge significantly alter myocardial strain measurements. Using a straight region of interest (ROI) excluding the bulge, rather than a true contour ROI, provides more robust strain data, especially for midwall strain.

Keywords:
EchocardiographyEndocardial trackingFull wall trackingLayer strainRegional hypertrophySpeckle-tracking

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Abnormal myocardial shapes, such as regional hypertrophy and septal bulge, can impact the accuracy of strain measurements.
  • Different echocardiographic tracking approaches may yield varying results when assessing myocardial strain in the presence of such abnormalities.

Purpose of the Study:

  • To evaluate the impact of abnormal myocardial shapes, specifically regional hypertrophy and septal bulge, on longitudinal strain measurements.
  • To compare the effects of different tracking approaches and region of interest (ROI) definitions on strain assessment in patients with septal bulge.

Main Methods:

  • Forty patients with normal ejection fraction and prominent septal bulge were selected.
  • Longitudinal strain was assessed using full wall (FW) and endo-, mid-, and epicardial (EME) tracking.
  • Two types of ROIs were used: a true contour ROI and a straight ROI excluding the bulging region.

Main Results:

  • Absolute segmental longitudinal strain values were significantly higher in bulged segments with a straight ROI compared to a true contour ROI for both FW and EME tracking.
  • The endocardial layer showed the most significant difference in strain values (P < 0.001).
  • Bulged segments influenced global longitudinal strain measurements, particularly in the endocardial layer (P < 0.001).

Conclusions:

  • Regional bulging significantly affects both global and segmental strain measurements.
  • Endocardial strain values from EME tracking with a true contour ROI are most sensitive to bulging.
  • Midwall strain values from FW tracking using a straight ROI are most robust against the effects of bulging.