Tissue Doppler imaging (TDI) measurements are relatively new Doppler techniques for assessing left ventricular diastolic function. Selective measurements of tissue contraction and relaxation velocities at the mitral annulus can detect left ventricular dysfunction more accurately than conventional echocardiography. As left ventricular diastolic dysfunction is an early event during allograft rejection, these techniques may be useful for detecting rejection non-invasively. Few studies have shown that Doppler tissue imaging of the mitral annulus is useful in diagnosing heart transplant rejection (1-3).