Cronicon OPEN ACCESS EC CARDIOLOGY EC CARDIOLOGY Mini Review Difficulties and Pitfalls in Performing Speckle-Tracking Echocardiography to Assess Left Ventricular Systolic Function Ana Feijão 1 , Savarino Victória Pereira 2 and Humberto Morais 3 * 1 Department of Cardiology, Luanda Medical Center, Luanda, Republic of Angola 2 Cardiology Service, Hospital Américo Boavida. Luanda, Republic of Angola 3 Department of Cardiology, Hospital Militar Principal/Instituto Superior, Luanda, Republic of Angola Citation: Humberto Morais., et al. “Difficulties and Pitfalls in Performing Speckle-Tracking Echocardiography to Assess Left Ventricular Systolic Function”. EC Cardiology 7.8 (2020): 30-35. *Corresponding Author: Humberto Morais, Department of Cardiology, Hospital Militar Principal/Instituto Superior, Luanda, Republic of Angola. Received: July 17, 2020; Published: July 17, 2020 Abstract Left ventricle systolic function is one of the most important measurements in cardiac evaluation. Transthoracic echocardiography is the most common and quickest technique to access qualitative and quantitative left ventricle systolic function mainly by the cal- culation of left ventricular ejection fraction (LVEF). However, despite its overwhelming clinical utility, LVEF has several limitations: it doesn’t detect small changes in the contractile function and it also doesn’t diagnose subclinical myocardial damage which has im- portant implications in the therapeutic choice and in the clinical protocol. In turn, strain imaging provides an accessible, feasible and non-invasive technique to assess cardiac mechanics, and speckle tracking echocardiography (STE) is the primary modality with the utility for detection of subclinical ventricular dysfunction. For this purpose a high-quality images are required. This article describes the main difficulties and pitfalls in the acquisition and analysis of left ventricular systolic function by STE. Keywords: Speckle Tracking Echocardiography; Left Ventricular Systolic Function; Ejection Fraction Introduction Assessment of left ventricular systolic function is a key element in echocardiographic assessment and traditionally it is based mostly on the quantification of left ventricular ejection fraction (LVEF). But in the last years for this purpose, myocardial wall deformation (strain) calculated with speckle-tracking echocardiography (STE) has gained increasing acceptance in clinical and echocardiographic evaluation [1]. This article presents the basic concepts of STE, and describes the main difficulties and pitfalls in the acquisition and analy- sis of left ventricular systolic function by STE. Definition STE allows evaluation of myocardial mechanics, and quantification of systolic function, by strain and strain rate (SR) [1]. Strain is a measure of myocardial deformation of a segment in relation to its original dimension and it is expressed as a percentage. SR is a measure of the rate (velocity) at which that myocardial deformation occurs and it is expressed in seconds [1,2].