Objective To explore the application value of tissue mitral annular displacement technique (TMAD) in evaluating left atrial function in coronary heart disease patients with different levels of coronary artery lesions.Methods According to Gensini score based on the coronary angiography results, 88 patients with suspected coronary heart disease were divided into control group(Gensini score =0，n = 30), mild lesion group（Gensini score 0～25，n = 30）and moderate to severe lesion group（Gensini score ≥25，n = 28）. Firstly, left atrial total ejection fraction（LATEF）,left atrial passive ejection fraction（LAPEF） and left atrial active ejection fraction（LAAEF）were obtained by biplane Simpson method. Left atrial filling period displacement（TMAD-D）, left atrial passive ejection period displacement（TMAD-P）and left atrial systolic period displacement（TMAD-S）were obtained by TMAD technique . The differences among the three groups were compared. Then, the correlation between TMAD-D and LATEF, TMAD-P and LAPEF, TMAD-S and LAAEF，and the correlation between TMAD parameters and Gensini score were analyzed. Finally, the ROC curve was drawn and the diagnostic value of TMAD parameters for moderate to severe coronary artery disease was discussed.Results Compared with the control group, LATEF, LAPEF,TMAD-D and TMAD-P in the mild lesion group decreased, LATEF, LAPEF, LAAEF, TMAD-D, TMAD-P and TMAD-S in the moderate to severe lesion group decreased , compared with the mild lesion group, LATEF, LAPEF, LAAEF, TMAD-D, TMAD-P and TMAD-S in the moderate to severe lesion group decreased (all P <0.05). In the lesion group, TMAD-D and LATEF, TMAD-P and LAPEF, TMAD-S and LAAEF were positively correlated (r = 0.856, 0.847,0.774 , respectively, all P <0.001). In the lesion group, TMAD-D, TMAD-P and TMAD-S were negatively correlated with Gensini score (r = -0.765,-0.551 and -0.531, respectively, all P <0.001). The area under the curve(AUC)of TMAD-D, TMAD-P and TMAD-S in the diagnosis of moderate to severe coronary artery disease were 0.951, 0.841 and 0.835, respectively (all P <0.001). Conclusion TMAD technique is a simple and reliable method to evaluate left atrial function in coronary heart disease patients with different levels of coronary artery lesions, and it can provide certain clinical value for non-invasive evaluation of the severity of coronary artery disease.