Echocardiography and a quest of the promised land of the accurate assessment of cardiac mechanics

Abstract

This editorial refers to ‘Feasibility and reproducibility of left ventricular rotation parameters measured by speckle tracking echocardiography’ by Bas M. van Dalen et al ., pp. 669–76, ‘Interpretation of two-dimensional and tissue Doppler-derived strain (1) and strain rate data: is there a need to normalize for individual variability in left ventricular morphology?’ by David Oxborough et al ., pp. 677–82, and ‘Echocardiographic assessment of left ventricular untwist rate: comparison of tissue Doppler and speckle tracking methodologies’ by V. Ferferieva et al ., pp. 683–90, in this issue. Echocardiography is in the midst of revolution. Its cause is the emergence of the new techniques to quantify segmental systolic and diastolic function. However, as in all revolutions, ‘old’ ways may be held in low esteem, whereas ‘new’ ways are held in awe, although frequently with insufficient information to support these views. Early in this last decade, we witnessed the emergence of segmental strain measurements based on tissue Doppler imaging (TDI). While initial studies showed good correlation with magnetic resonance imaging, later studies demonstrated that, compared with assessment of velocities, variability in the measurement of strain was much higher. Additionally, this new method required defining normal ranges of segmental strain as functions of age, gender, and wall location within the heart, work that has not yet been fully completed.1 Fast on the heels of TDI-based strain, speckle tracking echocardiography (STE) has been introduced, …