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Cardiac resynchronization therapy (CRT) is an established therapy for selected heart failure (HF) patients to improve symptoms, ventricular function, and survival. Although increasingly used, left ventricular (LV) dyssynchrony assessment by echocardiography has failed to show enough predictive value to assess patient response to CRT and the current guidelines do not recommend its routine use. Furthermore, a variety of echocardiographic techniques used for the purpose, including tissue Doppler imaging (TDI), real time three-dimensional echocardiography, M-mode, and various Doppler parameters, showed limited value and poor agreement between the studies and methods, greatly influenced by interobserver variability. Speckle tracking echocardiography (STE) is a more recent approach that uses strain imaging to assess LV dyssynchrony. This article discusses the speckle tracking for LV dyssynchrony and its current clinical applications.

Speckle Tracking for Assessment of Left Ventricular Dyssynchrony