Two-Dimensional Strain Imaging: Basic principles and Technical Consideration

Tissue Doppler Imaging (TDI) and TDI-derived strain provide considerably accurate information in the non-invasive assessment of local myocardial functions. Given its high temporal and spatial resolution, TDI allows assessment of local myocardial functions in each phase of cardiac cycle. However, the most important limitation of this method is its angle dependence. New techniques to measure myocardial deformation, such as speckle tracking echocardiography, overcome the angle-dependence limitation of TDI-derived strain. Moreover, these techniques provide more unique information about myocardial fiber orientation. This review examines the architectural structure and function of the myocardium and includes technical revisions of this information that will provide a basis for STE.