This is the first clinical validation of model-based, automated, voxel strain imaging using real-time 3D (nonstitched) echocardiography.

The authors measured regional and slice 3D rotational mechanics and compared this to tagged and feature-tracking CMR.

This novel automated 3D strain technique is accurate and reproducible (including test-retest variability) compared with CMR.

Automation may enhance work flow and clinical adoption and has a positive impact on reproducibility.