We applaud Sturgess et al (1) for their report on tissue Doppler imaging (TDI) in critical illness. Although their patients were selected and TTE performed at variable times after ICU admission, they provide a glimpse into the use of TDI and have generated many hypotheses. Indeed, there is a paucity of data regarding TDI in the critically ill, and further studies evaluating echocardiographic parameters in this population are urgently needed.