arXiv:2507.10127v1 Announce Type: cross Abstract: Accurate motion estimation for tracking deformable tissues in echocardiography is essential for precise cardiac function measurements. While traditional methods like block matching or optical flow struggle with intricate cardiac motion, modern point tracking approaches remain largely underexplored in this domain. This work investigates the potential of state-of-the-art (SOTA) point tracking methods for ultrasound, with a focus on echocardiography. Although these novel approaches demonstrate strong performance in general videos, their effectiveness and generalizability in echocardiography remain limited. By analyzing cardiac motion throughout the heart cycle in real B-mode ultrasound videos, we identify that a directional motion bias across different views is affecting the existing training strategies. To mitigate this, we refine the training procedure and incorporate a set of tailored augmentations to reduce the bias and enhance tracking robustness and generalization through impartial cardiac motion. We also propose a lightweight network leveraging multi-scale cost volumes from spatial context alone to challenge the advanced spatiotemporal point tracking models. Experiments demonstrate that fine-tuning with our strategies significantly improves models' performances over their baselines, even for out-of-distribution (OOD) cases. For instance, EchoTracker boosts overall position accuracy by 60.7% and reduces median trajectory error by 61.5% across heart cycle phases. Interestingly, several point tracking models fail to outperform our proposed simple model in terms of tracking accuracy and generalization, reflecting their limitations when applied to echocardiography. Nevertheless, clinical evaluation reveals that these methods improve GLS measurements, aligning more closely with expert-validated, semi-automated tools and thus demonstrating better reproducibility in real-world applications.