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Echocardiography remains the modality of choice for diagnosing heart disease in routine clinical practice. However, to date, the clinical approaches to evaluate regional myocardial function remain subjective and relatively poorly reproducible. As such, new ultrasound methodologies have been proposed in recent years in order to make this evaluation more quantitative and robust. This article reviews the technical principles behind these approaches as well as the clinical evidence that is already available showing the applicability and usefulness of these methodologies in daily clinical practice.