European Journal of Molecular & Clinical Medicine

Abstract

Background:Ischemic heart disease is the number one cause of mortality worldwide resulting in
7 million of the 53 million deaths in reported in 2010. Acute coronary syndrome is divided into
ST-elevation myocardial infarction (STEMI), Non ST-elevation myocardial infarction
(NSTEMI) and unstable angina. NSTEMI and unstable angina share similar pathophysiology
and have similar clinical presentation with the only difference is positive cardiac biomarkers
(cardiac Troponins and CK-MB) in the case of NSTEMI. Two dimensional (2D) speckle
tracking echocardiography is a relatively new imaging technique. Like tissue Doppler imaging
(TDI), it allows calculation of myocardial velocities and distortion parameters like strain and
strain rate (SR) giving important information for assessment of systolic and diastolic function,
particularly longitudinal strain, which both sensitive and specific in post myocardial. The main
advantage of speckle tracking analysis is its ability to assess several planes (circumferential,
radial and longitudinal) giving accurate data about LV dimensions and deformation with good
correlation to tagged cMR and sonomicrometry as reference methods.The accuracy and
sensitivity of detecting MI visually by detecting segmental wall motion abnormalities are
moderate and operator dependent but improve greatly by using speckle analysis.