Doppler tissue imaging variables were measured in 18 healthy men and women during supine bicycle stress exercise and upright exercise treadmill testing. From a color Doppler tissue imaging cineloop, tissue velocities in basal and mid segments of the standard 3 apical views during rest and peak exercise were assessed. Compared segments were adjusted for double product, and peak variables were compared using the paired t test. Peak systolic velocity and strain rate increased with both forms of exercise (P < .03). Time to compression-expansion crossover shortened in all segments with exercise and at peak exercise treadmill testing versus peak supine bicycle stress exercise (P < .03). Of all segments, 81% were analyzable for peak systolic velocity, 79% for strain rate. Doppler tissue imaging is a feasible tool for quantitatively assessing left ventricular response to supine and upright exercise.