Abstract: AIM:To evaluate the application of two-dimensional strain imaging (2DS) in assessing the left ventricular function in patients with chronic renal diseases. METHODS: One hundred patients with chronic renal diseases were divided into three groups: group A (n=30), group B (n=30) and group C (n=40) according to the severity of the renal disease and underwent 2DS. Thirty two healthy subjects were recruited as control group. Four-chamber apical views, two-chamber apical views and left ventricular long-axis views of two-dimensional images were stored. Longitudinal strain (S) and early diastolic strain rate (SRe) of left ventricular segments were obtained by 2DS software. RESULTS: Compared with those in the control group, the S and SRe in some segments in group A decreased and except for the S of the apical anteroseptum and the basal and middle segments of inferior wall, the S and SRe of each wall of left ventricle in group B also decreased. The S and SRe of all segments in group C significantly decreased compared with those in the control group. Except for the cardiac middle segment of anterior wall and the cardiac apex of inferior wall, the SRe of each wall of the left ventricle in group C decreased compared with those in group A. Global longitudinal peak systolic strain (GLS) in group B and group C significantly decreased compared with that in the control group. CONCLUSION: Two-dimensional strain imaging can detect early left ventricular dysfunction in patients with chronic renal diseases.