Objective To analyze longitudinal motion of infarcted myocardium and ischemic myocardium with a new echocardiographic technology of velocity vector imaging (VVI), and to assess its accuracy. Methods From December2007 to January 2008, 6 patients suffered acute anterior myocardial infarction (MI group), 9 patients had myocardial ischemia (over 70% stenosis of anterior descending branch, MS group) and 16 healthy subjects (control group) were included. The long axis view and 2-chambers view of left ventricle at the apex of heart were acquired with Siemens Sequoia 512 ultrasound system. The longitudinal velocity, displacement, strain and strain rate were analyzed with off-l ine Syngo US workplace software. Results In normal myocardial group, longitudinal peak systol ic velocity (Vs) and peak displacement (D) decreased progressively from base level to apex level in anterior wall and anterior septum (P lt; 0.05), while peak strain (S) and peak systol ic strain rate (SRs) kept the same in three levels (P gt; 0.05). S and SRs significantly decreased in all segments of infarcted myocardium (P lt; 0.05), compared with normal and ischemic myocardium. In ischemic myocardium, only base and middle segmental S of anterior wall decreased (P lt; 0.05). A myocardial S lower than —6.94% in at least one ventricular segment showed best sensitivity (100%) and specificity (100%) for detecting an infarcted left ventricle. A myocardial SRs lower than —0.81% at least in one ventricular segment showed 100% sensitivity and 80% specificity, and lower than —0.46% showed 83% sensitivity and 100% specificity. Conclusion VVI is a useful tool for assessing myocardial regional function. Especially, S and SRs are useful predictors of the presence of regional dysfunction in infarcted myocardium.