Speckle tracking imaging in inflammatory heart diseases

  • Marina Leitman
  • Zvi Vered
  • Vladimir Tyomkin
  • Boris Macogon
  • Gil Moravsky
  • Eli Peleg
  • Laurian Copel
Original Paper


Accurate diagnosis of acute myocarditis is important for the prognosis and risk stratification of these patients. Cardiac magnetic resonance (CMR) has become a major modality for diagnosis of myocarditis, but not widely available. In this study, we tried to evaluate regional and global longitudinal strain by speckle tracking echocardiography in patients with acute inflammatory myocardial diseases in correlation with CMR. Patients with suspected acute myocarditis were recruited prospectively. Clinical diagnosis was established based on clinical, electrocardiographic, laboratory and conventional echocardiographic data. All patients underwent CMR and repeat echocardiographic examination within 24 h of CMR. Echocardiographic examinations were analyzed offline with speckle tracking imaging software. Thirty-two patients with acute perimyocarditis and myopericarditis were included. Mean age was 29 ± 8, 30 males. All patients presented with chest pain and an abnormal electrocardiogram, in 28 ST elevation was found. Troponin was elevated in 30 and was 0.7 ± 0.5 ng/ml. Creatine kinase was 487 ± 319 U. LVEF was 56 ± 5%. Wall motion abnormalities were present in postero-lateral (53%), and inferior wall (21%). Delayed enhancement on CMR was found in 29 patients. Echocardiographic EF based on speckle tracking imaging correlated with CMR calculated EF. There was a positive correlation between the amplitude of regional strain and delayed enhancement, r = 0.52. Sensitivity and specificity of regional strain for prediction of delayed enhancement was 85 and 73% respectively. Speckle tracking imaging can help in the diagnosis of acute myocarditis when CMR is not readily available. Speckle tracking imaging based EF correlates with CMR calculated LVEF and with global strain.


Myocarditis Speckle tracking imaging Strain CMR 



No funding was received.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

Ethical approval

Our study was approved by the local Helsinki Committee and was done in accordance with the ethical standards of the local Helsinki Committee.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Science+Business Media B.V., part of Springer Nature 2017

Authors and Affiliations

  • Marina Leitman
    • 1
    • 3
  • Zvi Vered
    • 1
    • 3
  • Vladimir Tyomkin
    • 1
  • Boris Macogon
    • 2
    • 3
  • Gil Moravsky
    • 1
    • 3
  • Eli Peleg
    • 1
    • 3
  • Laurian Copel
    • 2
    • 3
  1. 1.Department of CardiologyAssaf Harofeh Medical CenterTzrifinIsrael
  2. 2.Department of RadiologyAssaf Harofeh Medical CenterTzrifinIsrael
  3. 3.Sackler School of MedicineTel Aviv UniversityTel AvivIsrael

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