الفهرس 
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Abstract
With the aging population, the number of patients with heart failure is rising along with significant morbidity and mortality. HF is the most common diagnosis in patients 65 years or older in many nations. It is expected that by the year 2030 there will be a 46% increase in the occurrence of HF with approximately 970.000 new cases each year. HF is defined as a complex clinical syndrome related to functional or structural impairment of ventricular filling or ejection of blood. There are two major categories of heart failure that are based on systolic and diastolic dysfunction. if the left ventricular ejection fraction (LVEF) is below 40% the patient typically has a dilated heart with systolic dysfunction and is diagnosed with HF with reduced ejection fraction (HFrEF). However, if the patient presents with a LVEF that is equal to or greater than 50% there is irregularity in the filling properties, and the patient is diagnosed with HF with preserved ejection fraction (HFpEF). The definition of HF has now expanded to include HFpEF as borderline (EF40-49%) and HFpEF improved (EF more than 50%). Approximately 50% of patients with this clinical syndrome have HFpEF because of the additional risk factors of aging, hypertension, obesity, and coronary artery disease. Thus, accurate and precise diagnostic assessment of myocardium using echocardiography is essential. Two-dimensional (2D) echocardiography is used for patients with HF to visually assess left ventricle (LV) function. Often the echocardiographic interpretations are subjective and result in semi-quantitative data. A more sophisticated software package called speckle-tracking echocardiography (STE) provides superior quantification of both regional and global LV systolic and diastolic function. With new imaging and software capability, clinicians and researchers can better evaluate the left atrium (LA), which is a crucial measurement in HF. The development in recent years of using STE to examine myocardial deformation and imaging the LA and LV has allowed more precise evaluation of the myocardium in patients with HFpEF. Early detection of diastolic dysfunction by STE would improve clinicians understanding and management of the signs and symptoms of HFpEF. The aim of the work was to assess the value of speckle tracking in assessment of heart failure with preserved ejection fraction. This was a prospective study in a cohort of 200 consecutive adult patients aged 18 to 70 years old with heart failure with preserved ejection fraction who was attempted transthoracic speckle tracking echocardiography at Tanta university hospital in cardiovascular unit between October 2022 and October 2023.