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Figure 2 Tissue Doppler Imaging (TDI) and TDI-Derived Strain Assessment in Patients With HCM

(A) Myocardial tissue Doppler velocity tracings from 4 representative regions of interest (ROIs) in a patient with HCM. Note significantly attenuated systolic and early diastolic velocities from disparate ROIs in the septum. (B) Tissue Doppler-derived longitudinal strain curves in the same areas shown in (A) and corresponding parametric color strain map. Note positive longitudinal strain (systolic lengthening) or "paradoxical strain" (blue and green tracings) in 2 of the 4 depicted ROIs (basal septum) and attenuated longitudinal strain elsewhere (yellow tracing). Note striking heterogeneity of strain tracings in contrast to tissue Doppler data. AVO = aortic valve opening, AVC = aortic valve closure; other abbreviations as in Figure 1.