Myocardial velocity gradient is a new indicator of regional left ventricular contraction determined by a two dimensional tissue Doppler imaging technique. The main goal of this study was to compare myocardial velocity gradient in patients with old myocardial infarction and dilated cardiomyopathy to normal subjects. We assessed myocardial velocity gradient in 44 persons: 32 patients (19 men, 13 women, mean aged 51.2 +/- 6.1 years) and 12 healthy subjects (7 men, 5 women, mean age 49.3 +/- 8.3 years) who were divided into 4 groups. Group A--14 patients with old anteroseptal myocardial infarction, group B--7 patients with old posterior infarction, group C--11 patients with dilated cardiomyopathy and group D--12 healthy subjects. In normal subjects myocardial velocity gradient in the anteroseptal segment was mean 2.44 +/- 0.34 s-1 and in the posterior segment was 3.08 +/- 0.38 s-1. Myocardial velocity gradient in the infarct regions was significantly lower than in noninfarct regions as well as that in the corresponding regions in normal subjects. Gradient in the anteroseptal and posterior segments was in group A: 0.61 +/- 0.33 s-1 12.39 +/- 0.65 s-1, p < 0.001 respectively and group B: 2.11 +/- 0.45 s-1 10.91 +/- 0.34 s-1, p < 0.001 respectively. In patients with dilated cardiomyopathy gradient was significantly lower (nteroseptal segment 0.55 +/- 0.37 s-1, posterior segment 0.85 +/- 0.31 s-1) than that in normal subjects (p < 0.001). CONCLUSIONS Myocardial velocity gradient is a new indicator for the quantitative assessment of regional left ventricular contraction.