Introduction: Two-dimensional speckle tracking imaging allows noninvasive measurement of left ventricular (LV) strain and rotation. We investigated whether circumferential and radial strain and rotation would be depressed during coronary vasospasm in positive ergonovine echocardiography. Methods: Mid LV short-axis images at baseline, spasm provocation and after nitroglycerin were acquired in 18 patients with positive ergonovine echocardiography. Using commercially available 2-dimensional strain software, time domain speckle tracking was performed, and regional and average LV circumferential strain, radial strain and rotation were obtained retrospectively. Results: Regional circumferential strain was significantly reduced during vasospasm provocation compared with baseline (-22.1짹7.6% to -9.58짹8.6%, p<0.0001). Regional radial strain was significantly reduced during vasospasm provocation (58.4짹24.3% to 36.2짹23.3%, p=0.004). Average circumferential strain and radial strain wad also reduce repectively (-19.22짹3.7% to -14.83짹3.9%, p=0.001, 58.2짹22.9% to 43.2짹21.9%, p<0.05). But, mid ventricular rotation was not changed (positive, 2.8짹1.8째 vs 3.1짹2.0째; negative, -3.4짹2.4째 vs -2.8짹1.4째) Regional circumferential strain was significantly increased after nitroglycerin compared with baseline(-22.1짹7.6% to -28.3짹6.9%, p=0.006) Conclusions: Segmental circumferential and radial strain was depressed during coronary spasm in positive ergonovine echocardiography. Average strain was also depressed.