Objective Tei index measured by tissue Doppler imaging was used to evaluate left ventricular function in patients with arteriovenous fistula (AVF) hemodialysis and to investigate the effect of long-term different flow loads on left ventricular function.Methods A prospective,single-blind,case-control study was conducted.Sixty patients with arteriovenous fistula were enralled.The patients were divided into Qa < 1000 ml/min group, Qa1000 ~ 2000ml/min group, and Qa > 2000ml/min group according to the different access flow (Qa) .Left ventricular function indicators and Tei index were measured one week before , 6 months and 12 months after surgery.The correlation between Tei index and left ventricular function indicators was analyzed. Results Repeated measurement variance analysis showed that the effects of different access flow on EF、FS、E/A、Ea/Aa、Tei were statistically significant (all P < 0.001).The effect at different time points on EF、FS、E/A、Ea/Aa、Tei were statistically significant (all P < 0.001). The interaction effects of different access flow and different time on EF、FS、E/A、Ea/Aa、Tei were statistically significant (all P < 0.001).EF、FS、E/A、Ea/Aa、Tei index in Qa < 1000 ml/min group at 6 and 12 months after surgery comparing with before surgery were not statistical significance (P > 0.05), Ea/Aa in Qa1000 ~ 2000ml/min group at 6 and 12 months after surgery decreased comparing with before surgery and the Tei index increased (P<0.05).The EF, FS, E/A and Ea/Aa in the Qa>2000ml/min group at 6 and 12 months after surgery decreased comparing with before surgery and the Tei index increased (P<0.05). Correlation analysis suggested that Tei index was negatively correlated with ejection fraction (EF), fractional shortening(FS), mitral valve flow velocity ratio (E/A), mitral annulus movement velocity ratio (Ea/Aa).(r=-0.634、-0.622、-0.569、-0.597 respectively，all P<0.01）.Conclusion Arteriovenous fistula with different flow load has different impacts on left ventricular function with time migration. The monitoring of cardiac function should be performed regularly.Tei is a comprehensive index for evaluating cardiac systolic and diastolic function, which can be used as an important basis for monitoring cardiac function after AVF operation.