A cardiac wall motion compensation system quantitatively compares images acquired at different phases of cardiac and respiratory movement and excludes motion contributed by respiratory movement. A system compensates for respiratory motion induced tissue displacement in cardiac wall motion determination. The system includes an imaging device for acquiring multiple sequential cardiac images of a patient and a data processor. The data processor processes data representing first and second images selected from the multiple sequential cardiac images, to determine heart wall respiratory motion representative displacement from a ventricle wall positional difference indicated between the first and second images, in response to a respiratory motion representative signal and a heart electrophysiological signal. The data processor subtracts heart wall respiratory motion representative displacement from a heart wall displacement measurement to provide a respiration compensated heart wall displacement value.