Background: Evaluating left ventricular(LV) contractile function in patients with mitral regurgitation(MR) is a difficult clinical problem. Although LV peak dP/dt measured by Doppler echocardiography has been shown to be a good marker for LV contractility, it is limited clinically due to the complexity of the measurement and the difficulty in obtaining appropriate Doppler tracings in patients with eccentric MR. We hypothesized that systolic mitral annulus velocity(S���) can be a simple and feasible marker of LV peak dP/dt. Methods: We studied 62 patients(25 men, age: 47짹15 years) who had 3+ or 4+ MR with normal LV systolic function(EF>50%). Peak dP/dt-Doppler was measured using MR jet tracing as previously reported. S��� velocity was measured at the septal annulus using Doppler tissue imaging. In 10 patients, LV pressure was measured with millar catheter and peak dP/dt-cath was calculated. Results: Mean LV EF was 60짹6% and regurgitant fraction was 59짹15%. Despite normal LV EF, peak dP/dt-Doppler ranged from 710 to 2133 mmHg/sec. S��� velocity was correlated well with peak dP/dt-Doppler(r=0.53, p<0.01). In 10 patients who underwent LV cath, peak dP/dt-Doppler correlated well with peak dP/dt-cath(r=0.68, p=0.06). Whereas S���velocity could be measured in all patients, peak dP/dt-Doppler could not be measured in 20 patients(32%) due to eccentric jet direction. Conclusion: Systolic mitral annulus velocity is a simple and feasible marker of LV peak dP/dt and, therefore, may be useful for assessing myocardial contractile function in patients with MR.