Objective To evaluate the longitudinal layer-specific strain of patients with coronary chronic total occlusion (CTO) before and 1 day after the percutaneous coronary intervention (PCI) by two-dimensional speckle tracking imaging (2D-STI),and then to explore the clinical value of PCI for patients with CTO. Methods A total of 30 patients diagnosed with CTO through coronary angiography and successfully taken the PCI procedure were enrolled in this study.Twenty-nine healthy volunteers were set as the control group.All patients were assigned to take echocardiography 1 day before and 1 day after PCI. The apical four-chamber (4CH),apical two-chamber (2CH) and the apical long-axis ( APLAX) echocardiographic images of all subjects were acquired.Left ventricular end-diastolic volume (LVEDV), end-systolic volume (LVESV),ejection fraction (LVEF) and stroke volume (LVSV) were measured.The mitral annular lateral S′,septal S′and average S′by tissue Doppler imaging (TDI) were also measured.The longitudinal layer-specific strain was analysed by 2D-STI.Results Compared to the control group,CTO group showed a decreased endocardial,midcardial and epicardial longitudinal strain of 4CH,2CH and APLAX ( P < 0.05). The global endocardial,midcardial and epicardial longitudinal strain were also decreased ( P <0.05).On the first day after PCI,these measures were increased compared to those on the first day before PCI (P<0.05) but the endocardial longitudinal strain of APLAX,2CH and GLS were still decreased compared to those of the control group ( P <0.05).The mitral annular lateral S′,septal S′and average S′of CTO group were decreased compared to those of the control group ( P <0.05).On the first day after PCI,the mitral annular lateral S′,septal S′and average S′were increased ( P <0.05) but showed no significant difference compared to the control group ( P > 0.05).All the other measures showed no significant difference among the three groups ( P >0.05).Conclusions The longitudinal strain of patients with CTO is decreased compared to that of healthy people and increased after PCI.