March 2011

This document represents the consensus of the writing group assembled jointly by the ASE and the EAE to survey the techniques currently available to assess myocardial mechanics. The consensus is that the techniques described in this document significantly contribute to the much needed process of the transformation of echocardiography from a subjective art of image interpretation to a set of objective diagnostic tools. Although the published research provides the evidence basis for potential clinical applications of these techniques in multiple clinical scenarios, the Writing Group believes that in the majority of areas, this methodology is not yet ready for routine clinical use. The consensus is that (1) additional testing is needed in multicenter settings to better establish the diagnostic accuracy of Figure 30 Two different modalities proposed to quantify regional and global atrial deformation by 2D STE: (A) the use of the QRS onset as a reference point and measurement of the positive peak left atrial (LA) longitudinal strain and (B) the use of the P wave as the reference point to allow the measurement of a first negative peak LA longitudinal strain (LA systole), of a second positive peak LA strain (LA conduit function), and of their sum. Journal of the American Society of Echocardiography Volume 24 Number 3 Mor-Avi et al 307 the different parameters and their reproducibility in various disease states, (2) standardization is needed for what should be measured and how measurements should be performed, and (3) standardization among manufacturers is essential, as clinicians should be able to interpret data generated by different equipment irrespective of vendor. Once these conditions are met and the larger echocardiography community gains the necessary experience with these techniques, they promise to become an integral part of the ‘‘toolbox’’ of clinical echocardiography.