title: Global and segmental myocardial deformation by 2D speckle tracking compared to visual assessment.
abstract: OBJECTIVE
  To examine the feasibility and reliability of measuring global and segmental longitudinal strain (LS) compared to visual assessment of wall motion (WM).
  
  
  METHODS
  Assessment of segmental (17 left ventricular segments) LS using automatic function imaging (AFI) in 55 patients (60.0 ± 8.7 years, 73% male) divided into 2 groups: group I included 35 patients with WM abnormalities and/or impaired ejection fraction and group II included 20 patients with normal WM and ejection fraction. Visual analysis of WM abnormalities was performed using 2-dimensional echocardiography (2DE) and WM score was calculated. Both modalities were analyzed by one expert reader at 2 different sessions.
  
  
  RESULTS
  Analysis of 935 left ventricular segments was completed in 94.1% and 96.3% by visual assessment and AFI, respectively. There was a strong positive linear relationship between the WM score and global LS in all patients. Intra-observer agreement for calculation of WM score was excellent for group I patients (kappa: 0.97) and very good for group II patients (kappa: 0.92). Intra-observer agreement for AFI showed excellent agreement with very small mean difference in both group I and II (-0.0 ± 2.3 and -0.0 ± 1.9, respectively).
  
  
  CONCLUSIONS
  The interpretation of global and segmental LS using AFI is a more feasible and reliable technique for the quantification of myocardial deformation than visual assessment of WM scores.
authors.affiliation: Ashraf M Anwar, Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah 21159, Saudi Arabia.
authors.forename: Ashraf M
authors.initials: AM
authors.lastname: Anwar