Aim — to analyze longitudinal strain and strain rate of the left ventricle (LV) and papillary muscles of the mitral valve (MV) in patients with coronary artery disease (CAD) followed by different types of ischemic mitral regurgitation (MR) and without regurgitation. Material and methods. The study included 116 CAD patients aged 60.9±3.1 years. The majority of patients had severe manifestations of coronary insufficiency. Angina pectoris NYHA class III—IV was noted in 78% of patients, class II — in 22%. Symptoms of chronic heart failure (CHF) were observed in 62 (53%) patients (class I—II — 39%, class III—IV — 14%). Tissue Doppler images were obtained in the apical 4-chamber and 2-chamber positions. Four LV areas were evaluated: lateral, anteroposterior, posterior, anterior walls (basal and median segments), as well as anterior and posterior papillary muscles of the MV. The following values were calculated for each segment: strain (S) — systolic myocardial deformation, strain rate (SRs) — systolic rate of myocardial deformation, SRe — early-diastolic rate of myocardial deformation, SRa — late-diastolic rate of myocardial deformation. Three groups were analyzed: group 1 (n=33) with asymmetric MR jet along posterior medial commissure of the MV; group 2 (n=41) with central MR jet; group 3 (n=42 with CAD and mild MR (≤1)). Results. Analysis of longitudinal strain and strain rate showed that patients with ischemic MR had reduced longitudinal systolic deformation of all LV segments and papillary muscles in comparison with patients without MR. Longitudinal systolic myocardial deformation was also reduced in patients with CAD and no ischemic MR but it was less significant compared with patients with ischemic MR. It was observed decrease of SRs in patients with ischemic MR compared with CAD patients without MR. Patients with asymmetric MR jet had significant impairment of SRs of posterior LV wall and posterior papillary muscle whereas patients with central MR jet — diffuse decrease of SRs across all LV walls. Analysis of diastolic rates of myocardial deformation also showed reduced SRe and SRa in patients with ischemic MR compared with CAD patients without MR. Patients with asymmetric MR jet had impaired SRe and SRa of posterior LV wall and posterior papillary muscle while patients with central MR jet — diffuse decrease of diastolic strain rate of all LV segments. Conclusion. Contractility of posterior LV wall and posterior papillary muscle significantly influences formation of asymmetric jet of ischemic MR. Diffuse decrease of LV contractility is followed by central type of ischemic MR, LV enlargement and global remodeling.