Objective We tried to analyze the value of three-dimensional speckle tracking imaging technology combined with left ventricular pressure strain loop for evaluation of left ventricular systolic dysfunction in early coronary heart disease patients. Methods 97 patients with early coronary heart disease admitted to our hospital from February 2022 to February 2024 were selected as the research subjects. According to the degree of left ventricular systolic dysfunction， they were divided into those without left ventricular systolic dysfunction （LVEF value ≥ 50%） and those with left ventricular systolic dysfunction （LVEF value < 50%）. All patients underwent clinical data collection， left ventricular pressure strain loop， and three-dimensional speckle tracking imaging technology examination. Results Body mass index， gender， diabetes mellitus and hyperlipidemia were compared between the two groups （P > 0.05）. Compared with the group without left ventricular systolic dysfunction， the group with left ventricular systolic dysfunction is older， with a higher proportion of Killip grades Ⅲ~Ⅳ and multiple coronary artery lesions （P < 0.05）. Compared with the group without reduced left ventricular systolic function， the absolute levels of GWE， GCW， and GWI in the group with reduced left ventricular systolic function were lower， while the absolute level of GWW was higher （P < 0.05）. Compared with the group without left ventricular systolic dysfunction， the left ventricular systolic dysfunction group had lower levels of area， circumference， radial， and longitudinal strain （P < 0.05）. GWE、GCW、GWI、 Area， circumference， radial， and longitudinal strain levels were negatively correlated with the incidence of left ventricular systolic dysfunction， while GWW was positively correlated with the incidence of left ventricular systolic dysfunction （P < 0.05）. The ROC analysis results showed that the sensitivity and accuracy of left ventricular pressure strain loop and three-dimensional speckle tracking imaging technology in predicting left ventricular systolic dysfunction in early coronary heart disease patients were lower than combined detection （P<0.05）. Conclusions Early coronary heart disease patients with reduced left ventricular systolic function had lower absolute levels of area， circumference， radial， longitudinal strain， GWE， GCW， and GWI， and higher absolute levels of GWW. These indicators are all related to the incidence of left ventricular systolic dysfunction. The combination of three-dimensional speckle tracking imaging technology and left ventricular pressure strain loop had high value in predicting left ventricular systolic dysfunction in early coronary heart disease patients.