Focus of the Report: This report focuses on myocardial strain imaging (MSI) using speckle-tracking echocardiography for diagnosis and prognosis in patients who have dilated cardiomyopathy (DCM).

Technology Description: MSI involves a sophisticated analysis of images from echocardiography. Reflection of ultrasonic waves from myocardial tissue creates stable patterns of brighter and darker spots (speckles) that can serve as “fingerprints” to identify specific segments of the myocardial walls. Image processing computer software tracks the movement of these patterns to assess the severity of myocardial damage and abnormal heart function.

Controversy: Although the equipment needed to perform echocardiographic MSI is much less complicated than the equipment needed for cardiac magnetic resonance imaging, MSI may be less accurate and there is little evidence addressing the relative accuracy of these techniques.

Key Questions:

  • Does MSI improve diagnostic or prognostic accuracy in patients with DCM?

  • Does information obtained with MSI improve management of patients with DCM?

  • How does MSI compare with other technologies used to evaluate patients with DCM?

  • Are there safety issues associated with MSI?

  • Have definitive patient selection criteria been established for MSI in patients who have known or suspected DCM?

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