Speckle tracking imaging in normal stress echocardiography

Marina Leitman*, Vladimir Tyomkin, Eli Peleg, Izhak Zyssman, Simcha Rosenblatt, Edgar Sucher, Vered Gercenshtein, Zvi Vered

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives-Exercise stress echocardiography is a widely used modality for the diagnosis and follow-up of patients with coronary artery disease. During the last decade, speckle tracking imaging has been used increasingly for accurate evaluation of cardiac function. This work aimed to assess speckle-tracking imaging parameters during nonischemic exercise stress echocardiography. Methods-During 2011 to 2014 we studied 46 patients without history of coronary artery disease, who completed exercise stress echocardiography protocol, had normal left ventricular function, a nonischemic response, and satisfactory image quality. These exams were analyzed with speckle-tracking imaging software at rest and at peak exercise. Peak strain and time-to-peak strain were measured at rest and after exercise. Clinical follow-up included a telephone contact 1 to 3 years after stress echo exam, confirming freedom from coronary events during this time. Results-Global and regional peak strain increased following exercise. Time-topeak global and regional strain and time-to-peak strain adjusted to the heart rate were significantly shorter in all segments after exercise. Rest-to-stress ratio of timeto- peak strain adjusted to the heart rate was 2.0 to 2.8. Conclusions-Global and regional peak strain rise during normal exercise echocardiography. Peak global and regional strain occur before or shortly after aortic valve closure at rest and after exercise, and the delay is more apparent at the basal segments. Time-to-peak strain normally shortens significantly during exercise; after adjustment to heart rate it shortens by a ratio of 2.0 to 2.8. These data may be useful for interpretation of future exercise stress speckle-tracking echocardiography studies.

Original languageEnglish
Pages (from-to)717-724
Number of pages8
JournalJournal of Ultrasound in Medicine
Issue number4
StatePublished - 1 Apr 2017


  • Exercise stress echocardiography
  • Speckle tracking imaging


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