Clinical Applications of Speckle Tracking in Ischemic Heart Disease

Abstract

Background: Ischemic heart disease remains a major cause of myocardial dysfunction, and accurate assessment of regional and global left ventricular performance is essential for diagnosis, risk stratification, and therapeutic decision-making. Conventional echocardiographic evaluation based on visual wall-motion analysis and left ventricular ejection fraction is limited by subjectivity, operator dependence, loading conditions, and reduced sensitivity for early or subclinical dysfunction. Speckle tracking echocardiography is a noninvasive, angle-independent technique that tracks natural acoustic markers within the myocardium to quantify myocardial deformation. It enables assessment of longitudinal, circumferential, and radial strain, while global longitudinal strain provides a sensitive measure of overall left ventricular systolic function. In ischemic heart disease, speckle tracking can detect subtle regional abnormalities, identify myocardial ischemia before overt changes in ejection fraction, estimate the extent of ischemic injury, and help differentiate transmural from non-transmural scar. Accordingly, speckle tracking has become an important adjunct to conventional echocardiography, offering more objective and reproducible evaluation of myocardial mechanics and potentially improving diagnosis, prognostic assessment, and follow-up of patients with coronary artery disease.