Objective To analyze the correlation between two-dimensional speckle tracking layer-specfic strain parameters and leukocyte-associated inflammatory indexes in patients with coronary artery disease (CAD), and to explore the application value of the combination of the two in CAD diagnosis. Methods A total of 141 patients with suspected CAD (CAD group) who underwent coronary angiography due to chest pain in our hospital were selected, and according to the degree of coronary artery stenosis, they were divided into mild stenosis group (47 cases), moderate stenosis group (53 cases) and severe stenosis group (41 cases), and 30 healthy physical examination patients in the same period were selected as the control group.Collect the results of laboratory tests to calculate the ratio of lymphocytes to monocytes (LMR) and monocytes to high-density lipoprotein-cholesterol (MHR), The two-dimensional speckle tracking layer-specfic strain imaging was used to obtain the overall longitudinal strain of the left ventricular subendocardial, middle and subepicardial myocardium (GLSendo, GLSmid, GLSepi). The differences of the above parameters were compared, the correlation between LMR, MHR and each layer-specfic parameter was analyzed by Spearman correlation analysis, and the ROC curve of the subject was drawn to analyze the performance of LMR, MHR and GLSendo in diagnostic CAD alone and in combination. The intra-group correlation coefficient (ICC) was used to evaluate the consistency of strain parameters within and between observers. Results Compared with the control group, LMR and MHR were reduced in the mild, moderate and severe stenosis groups, GLSendo and GLSmid were reduced in the mild stenosis group, and GLSendo, GLSmid and GLSepi were reduced in the moderate and severe stenosis groups, and the differences were statistically significant (all P<0.05). Conclusions The two-dimensional speckle tracking layer-specfic strain parameters are correlated with leukocyte-associated inflammation indexes, and LMR, MHR combined with GLSendo have certain diagnostic value in CAD.