【Abstract】Objective:The aim of this study was to assess Left Ventricular functional change using three-dimensional speckle tracking echocardiography and its relationship to blood pressure variability in patients with prehypertension.Methods: A total of 58 prehypertensive patients were included, and the control group included 56 age- and sex-matched healthy volunteers. Conventional echocardiography and?three-dimensional?speckle-tracking?echocardiography (3DSTE) were performed and LV global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were measured.All patients were monitored by ambulatory blood pressure.Results: 3D-GRS, 3D-GAS, 3D-GCS were similar between prehypertensive patients and controls (P＞0.05). 3D-GLS was significantly reduced in patients with prehypertension compared to controls (P<0.05).Correlation analysis showed that 3D-GLS positively correlated with SBPV（r=0.540，P<0.001）and DBPV（r=0.526，P<0.001）. Conclusions: In patients with prehypertension, 3D -STE revealed lower longitudinal strain values than in healthy controls. RT3D-STE is a novel, feasible method to assess cardiac function and appears suitable to detect subtle left ventricular dysfunction.