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Figure 2 (A) Apical long-axis view in a patient with dilated cardiomyopathy and left bundle branch block. Solid lines mark the duration of systole (300 ms). The sample point is located at the base of the anteroseptal region. In this region, the peak velocity is 4 cm/s (arrow). (Lower left panel) Tissue tracking. From the color coding, it appears that the majority of the posterior wall is gray, indicating either no or paradoxical motion (i.e., motion away from the apex during systole). (B) The same patient as in part A, with the cursor positioned in the basal segment of the posterior wall. The interval between the solid lines in the right panel represents the duration (180 ms) of delayed longitudinal contraction (DLC), with a peak velocity of 6 cm/s (arrow). The onset of this DLC corresponds to the cessation of systole in the septum, as in part A, right panel. Tissue tracking (lower left panel) displays the extent of myocardium (colored segments) with DLC (diastole, open mitral valve). Note that the remaining part of the LV is gray, indicating either no motion or motion toward the base of the heart (relaxation). The strain rate is required to detect shortening or passive stretching.
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