We read with great interest the letter by Mr Ze-Zhou Song. Mr Song raises important issues on the impact of how deformation parameters such as strain and strain rate are influenced by several conditions and diseases other than myocardial infarction. This has previously been shown in hypertensive and diabetic patients without recognized ischaemic events as well as in other conditions. This aspect will have to be considered when interpreting our results, as well as in the clinical context. In our present study [1], we intentionally did not exclude patients with co-morbidities. We agree with Dr Hoffmann in his reply to a similar request from Mr Song in the European Heart Journal that an exclusion of patients with other conditions would reduce the applicability of the study in clinical practice [2]. The statistical power of our present...

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