Velocity and deformation imaging for the assessment of myocardial dysfunction

Recent developments in echocardiographic imaging technology and processing enabled the quantification of myocardial motion and deformation in a clinical setting. Echocardiographic strain (-rate) imaging provides a relatively easy way to study myocardial deformation. However, although (local) deformation is clearly linked to cardiac (dys-) function, it is important to understand how this information can be used in clinical practice and how specific deformation patterns should be interpreted. This review paper first discusses which issues are important to address when assessing cardiac function and how (regional) deformation and myocardial contractility are related. The use and interpretation of deformation profiles is further illustrated for some typical cardiac pathologies. The observed deformation patterns are discussed in light of the changes in regional contractility (ischemia), timing of contractile force development (LBBB and heart failure), pressure/volume overload, and assessing diastolic function.