Quantitative measurement of left ventricular wall motion can improve clinical diagnosis by providing a more objective approach than qualitative analysis, which is subject to large inter-observer variability. We have developed novel techniques for quantifying left ventricular wall motion in three-dimensional image data sets. In this study, finite element models simulating regional ischemia in the left ventricle were used to screen potential wall motion measures for their capability to detect and evaluate the size of an ischemic region. Preliminary experimental results showed that wall motion analysis of real-time three-dimensional echocardiographic images successfully detected ischemia. Our four-dimensional wall motion analysis system provides an objective and quantitative approach for detecting and assessing the severity of disease. ©2006 IEEE.