Regional endocardial motion and wall thickening of the left ventricle were quantitatively assessed in nine normal subjects and in 21 patients with coronary artery disease using two-dimensional echocardiography (2DE) and a computerized light pen system. Eight equal sectors of a cross-sectional image from parasternal short-axis, apical four-and two-chamber views were used for measuring sector area difference of endocardial motion and wall thickness between end diastole and end systole. In 13 patients with anterior wall motion abnormalities, area difference of wall thickening found by 2DE was abnormal in 12 of 13 (92%) patients, and only in 6 of 13 (46%) patients by endocardial motion. In 10 patients with dyskinetic regions in apex or anterior wall, dyskinesia by wall thickening was found in all patients, but only in 6 of 10 (60%) by endocardial motion. Thus, wall thickening assessed by 2DE is a more sensitive technique than analysis of endocardial motion in evaluating regional wall motion abnormalities in patients with coronary artery disease.