Objective To assess the changes and differences of left ventricular systolic blood flow field in hypertrophic cardiomyopathy (HCM) and hypertensive left ventricular hypertrophy (H-LVH) patients. Methods 25 HCM patients and 24 H-LVH patients were selected in this study, 35 healthy adults were enrolled as control group. The average energy loss, energy efficiency, intra-ventricular vortex circulation and area during isovolumic contraction and ejection stages were calculated, namely IVC-EL, Ej-EL; IVC-EE, Ej-EE; IVC-cir, Ej-cir; IVC-vor-area, Ej-vor-area. The total longitudinal strain (GLS), interventricular septal strain (IVS-LS) and posterior lateral wall strain (PLW-LS) were analyzed by two-dimensional speckle tracking technique. Results ① Compared to the control group, GLS decreased and IVC-EL and Ej-EL increased in HCM and H-LVH groups; Compared to control and H-LVH group, Ej-EE were higher and IVC-vor-area, Ej-vor-area, IVS-LS were lower in HCM group (P<0.05). ② The“ reverse vortex” was observed significantly more frequently in the HCM group (HCM 88% vs H-LVH 16.7%, P<0.05). ③ Multiple linear regression analysis showed that IVC-vor-area and GLS could independently predict Ej-EE (P<0.05). Conclusion The abnormal hemodynamics and differences between HCM and H-LVH can be reflected by systolic blood EE and intra-ventricular vortex parameters.