In patients with congestive heart failure, the left ventricular longitudinal myocardial velocity ejection fraction 2Sm, Em, and Am predict the left ventricular EF > 50% based on the ROC curve characteristics. This discusses traditional methods of measuring EF as a representative of global left ventricular function, where the main indicators reflect the shortening of ventricular annular fibers to evaluate changes in ventricular chamber volume, cardiac afterload-dependent indicators rather than a direct reflection of contraction. Additionally, the EF value may overestimate the actual systolic function and thus has certain limitations as a systolic function parameter according to EF. TDI determination of mitral annulus velocity assesses LV longitudinal dynamics; Sm reflects left ventricular longitudinal systolic function, Em reflects left ventricular diastolic longitudinal relaxation function, and Am reflects left atrial longitudinal systolic function. Peteiro and others have confirmed that TDI-measured mitral annular peak systolic sm correlates better with invasive dp/dt (r: 0.69, P < 0.001) than EF and dp/dt inter-correlation (r = 0.39, P: 0.05). The decline in systolic HF for this group of patients affects not only the left chamber longitudinal systolic function but also significantly reduces diastolic function, leading to pulmonary hypertension as reported by Bmcks. In this group of diastolic HF patients, left ventricular longitudinal systolic function does not change significantly, only affecting left ventricular compliance and pulmonary hypertension. Recent scholars have reported that diastolic HF patients exhibit reduced left ventricular longitudinal contraction speed Sm, indicating systolic dysfunction in diastolic HF, which is not independent. In fact, cardiac contraction and relaxation are closely coupled continuous processes, and individual I-IF patients may have varying degrees of systolic and diastolic dysfunction in combination. However, this study failed to reach a similar conclusion, possibly due to inconsistencies in the definition of normal EF and the smaller sample size in this study, requiring further investigation. This study found that TDI's Sm, Em, Am, E/Em correlate well with EF—Sm, Em, Am show higher sensitivity and specificity in predicting EF, with Sm being the strongest predictor. When Sm ≥ 4.62cm/s, it predicts EF ≥ 50% with a sensitivity of 91.4% and specificity of 89%. TDI detection of left ventricular longitudinal velocity is simple, non-invasive, rapid, accurate, reproducible, and almost independent of cardiac load, allowing for quantitative prediction of EF.