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Figure 3 Pitfalls of tissue Doppler-derived strain rate. (A) Reverberation (here related to rib artifact marked by an arrow and shown on the yellow curve) compromises the strain rate signal, contrasted with an adjacent normal strain rate signal (blue curve). (B) The importance of avoiding blood-pool activity, in which a noisy strain rate curve (yellow) is compared with a smaller sample size, tracked to myocardial movement (blue). (C) The limited spatial resolution of tissue Doppler, in which the blue curve (sample volume outside of the cardiac contour), although noisy, is comparable with the yellow curve that is appropriately tracked to the wall.