High-Frame-Rate Echocardiography: A New Frontier in Noninvasive Functional Assessment

High-frame-rate (HFR) ultrasound imaging enables the acquisition of up to several thousand frames per second, substantially improving the temporal resolution of echocardiography. This technical advancement allows visualization of rapid mechanical and hemodynamic events that are not captured by conventional systems. In this review, we summarize the methods used to achieve HFR acquisition and examine their application across three principal domains: deformation imaging, mechanical wave imaging, and blood flow imaging. In deformation imaging, clinical studies have demonstrated higher feasibility for myocardial motion tracking and more reliable temporal deformation parameters. Mechanical wave imaging has emerged as a complementary domain, using HFR acquisition to capture transient mechanical events and estimate regional myocardial stiffness under both physiological and pathological conditions. In flow imaging, improved temporal resolution enables detailed visualization of rapid intracardiac flow and the evaluation of complex hemodynamic patterns. This technology expands the scope of functional and quantitative cardiac assessment and is emerging as a valuable modality for noninvasive diagnosis and monitoring in cardiovascular disorders.