Although not limited by tethering, since measurements are in reference to myocardium and not to an immobile transducer, it is still subject to the Doppler angle limitation. Speckle tracking derives myocardial velocity in two dimensions from tracking of acoustic markers, produced by the interaction of ultrasound with tissue. Speckle tracking is not based on Doppler and measurements are independent from insonation angle and tethering. In addition, it is automated and provides regional as well as global measurements. Both Doppler strain and speckle tracking are not found wide-spread acceptance in everyday clinical practice. Currently, if the limitations are taken into consideration DTI can be a helpful diagnostic modality, offering quick, real time insights into clinical diagnostic challenge.