OBJECTIVES: Evaluation of left ventricular function and wall motion analysis is essential in patients with heart disease, especially ischemic heart disease. However, it is frequently limited by many factors ', obesity, chronic obstructive lung disease, etc. We conducted our study to know the feasibility of PMI technique, recently developed method to overcome these lirnitation. METHODS: We recorded echocardiography of consecutively admitted patients by ATL HDI 3000 and conducted LV wall motion analysis according to standardization of ASE and then recorded echocardiography again by PMI technique in 44 patients in which more than on left ventricular segments were poorly visualized. We compared the resolution of echocardiography of PMI technique with traditional echocardiography. We categorized the segments semiquantitatively ; grade A in which endocardium is clearly visualized, grade C in which endocardium is not discernible, grade B in which endocardium is suboptimally visualized. RESULTS: 1) 44 patients(30 males and 14 females) were studied and their rnean age was 63.4+/-10.5 years old. 2) 20 patients had myocardial infarction and 12 patients angina, 6 patients heart failure, 4 patients arrhythmia, and 2 patients other diseases. 3) Among total 704 segments, 462 segments(65.6%) were categorized as grade A, 203 segments(28.8%) as grade B, 39 segments(5.6%) as grade C. In 19 patients, more than one segments were categorized as grade C. In 6 patients, rnore than 3 segments were categorized as grade C. 4) With PMI technique, 557 segrnents(79.1%) were categorized as grade A, 126 segments (17.9%) as grade B, 21 segments(2.9%) as grade C with upgrade from grade C to A in 124 segments(17.6%) and grade C to B or B to A in 17 segments(2.4%). CONCLUSION: Echocardiography by PMI technique is feasible in left ventricular wall motion analysis in patients with poor echocardiographic windows.