【Abstract】Objective Myocardial strain of two-dimensional speckle tracking echocardiography (2D-STE) has been validated for cardiac function assessment. We sought to evaluate the changes of left ventricular (LV) myocardial strain of the global and regional longitudinal, radial and circumferential strain parameters in patients with valvular heart disease (VHD) and valve replacement for assessment of the clinical outcomes of VHD patients. Methods Thirty-five patients with VHD and valve replacement and twenty normal person were enrolled. LS less than -20% defines abnormal segments and layers of myocardium. 2D and strain variables of echocardiography were analyzed and compared with control group. Results Global and layer-specific longitudinal and circumferential strains were no significant improved in 1 week and 1 month after operation (P> 0.05). Compared with preoperative, territorial longitudinal strain (TLS) was significant improved in 1 month after operation (P <0.05), and it was also better than 1 week after operation (P <0.05). Territorial circumferential strain (TCS) of endocardial layer (TCSendo) was decreased which compared with preoperative. Territorial longitudinal strain (TLS) of endocardial and epicardial layers (TLSendo, TLSepi) were significantly improved in 1 month after operation while compared with preoperative (P <0.01), and TCSendo was also improved (P <0.05), Territorial circumferential strain (TCS) of epicardial layer (TCSepi) was no significant difference (P> 0.05). Compared with postoperative in 1 week, TLSendo, TLSepi were significantly improved in 1 month after operation (P <0.01) .There were no significant difference between 1 week and 1 month after operation by TCSendo and TCSepi (P> 0.05). Conclusion TLSendo is a sensitive indicator of the outcomes of VHD patients and better than LVEF and other strain variables by 2D-STE. Sensitive detection of LV dysfunction, especially myocardial strain parameters are valuable for the clinical therapeutic effect in short-term in patients with valve replacement.