Background: Heart failure with preserved ejection fraction (HFpEF) is a clinical disorder where patients have manifestations and indications of heart failure (HF) yet typical or close ordinary left ventricular ejection fraction (LVEF).(1)Approximately 50% of patients with this clinical syndrome have HFpEF because of the additional risk factors of aging, hypertension, obesity, and coronary artery disease (2,3).The occurrence of myocardial disease can precede structural myocardial changes shown by traditional imaging techniques. Accurate assessment of myocardial function is therefore particularly important in patients with potential to develop serious cardiac disease. Myocardial strain by two dimensional speckle tracking echocardiography(2D-STE) has demonstrated to be a sensitive tool for assessing ventricular function in early myocardial disease