Segmental strain analysis. A: Segmental based circumferential strain analysis at rest and during high-dose dobutamine in a patient without WMA and normal coronary angiogram. B: Segmental strain analysis in a patient, who developed a WMA of the anterolateral segment. The Ecc of the neighbouring anterior and inferolateral segments was also impaired. The coronary angiogram showed a corresponding high-grade stenosis of the first diagonal branch. C: Ecc analysis of basal, medial and apical SAX under high-dose dobutamine stress. The depicted strain curves originate from three different patients, who all developed a WMA. Angiography showed high grade stenosis of the left circumflex artery in the patient at the bottom (basal SAX). Both patients in the middle and at the top had stenoses of the left anterior descending artery.