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Objectives: We aimed to evaluate changes in left ventricular (LV) longitudinal systolic functions in the follow-up of patients with asymptomatic, non-ischemic, chronic mitral regurgitation (MR) by using velocity vector imaging (VVI)-based strain imaging.Methods: Fifty four MR patients (57.9±8 years, 55 % male) with normal LV ejection fraction (EF) and 30 healthy controls (56±6.5 years, 55 % male) were evaluated by both conventional echocardiography and Velocity Vector Imaging (VVI) based strain imaging at baseline. At the end of 12 months, measurements of 30 MR patients were repeated. To evaluate LV longitudinal systolic function, segmental peak systolic strain and strain rate (SRs) data were acquired from apical four chamber, two chamber and long axis views.Results: There was no significant change in LV dimensions and LV ejection fraction (EF) in the follow-up, compared to baseline study. Longitudinal peak systolic strain and SRs of the LV were decreased in patients with MR patients, compared to controls (strain: 16.29 ± 3.30 to 23.4 ±1.9, p=0.0001 and SRs: 0.93 ± 0.39 to 4.9 ± 0.6, p=0.0001) at baseline. The impairment was more significant in 12 months (strain: 13.76±2.68 and SRs: 0.27±0.14, p=0.0001) follow-up despite preserved LV EF.Conclusions: Left ventricular systolic dysfunction develops in patients with chronic MR. Detection of ventricular deterioration in the sub-clinical phase helps to prevent irreversible heart failure. Velocity vector imaging-derived strain and SRs may be used as adjunctive, noninvasive parameters in the assessment of subclinical LV dysfunction and its progress during clinical follow-up, in patients with chronic MR.