Objective: To investigate the changes of left systolic ventricular function after mitral valve replacement with different degrees of chordal preservation by using strain and strain rate imaging. Methods: A total of 55 patients undergoing mitral valve replacement were enrolled, including 20 receiving complete excision of the subvalvular apparatus (group A), 20 receiving preservation of the posterior chordopapillary apparatus only (group B) and 15 receiving total chordal preservation of chordal preservation (group C). Systolic peak strain (Ss) and systolic peak strain rate (SRs) were measured before operation, 7-10 days and 3 months after operation. Results: No significant difference of Ss nor SRs was found among 3 groups 7-10 days after operation. Three months later, Ss and SRs were significant different between each two groups, the changes of Ss and SRs in group C were greater than those in group B and A, in group B were greater than those in group A. Conclusion: Mitral valve replacement with preservation of total subvalvular apparatus is beneficial to the recovery of heart function. Copyright © 2013 by the Press of Chinese Journal of Medical Imaging Technology.