In this paper, a method for the detection of myocardium contractility defect from transthoracic echocardiography is proposed. Speckle phenomenon is considered here as useful functional information and not only as a multiplicative noise. Its distribution and frequential characteristics are used to derive boundary and regional energy terms in order to track myocardium walls with deformable contour models. Moreover, ultrasound density is also estimated from speckle moments to calculate myocardial displacement field from the solution of an inverse continuity equation problem. The clinical feasibility of local and global indices and a prospective study for the multisite stimulation are presented.