Background: longitudinal and radial systolic function are weakened by cardiac diseases and longitudinal one is weakened first. Assessment of left ventricular LV systolic function is important in management and prognosis of cardiac diseases. Mitral annular displacement MAD is used to assess LV longitudinal and global systolic function. Objectives: To validate the accuracy of MAD assessed by Doppler tissue imaging DTI and m-mode echocardiography MME as a surrogate for determination of LV systolic function in pationts with ischemic heart disease and/or heart failure, and maybe easy and fast way instead of conventional echocardiography assessment of LV function. This way permits to study the function of LV longitudinal cardiac fibers function while the conventional ways of echocardiography assesses the circumferential shortening. Patients and methods: We studied a series of 96 patients (men and women) with (ischemic heart diseases,heart failure) divided into three age groups and compared with another 59 healthy age matched volunteers as a control group. We selected subjects from AL ASSAD hospital /LATAKIA over the year 2014. A medical history, whole medical examination, ECG, conventional echocardiography were made to each subject. Ejection fraction EF of LV, Doppler recording of the mitral inflow, MME and pulse wave Doppler tissue imaging PW DTI data (from each four sites of mitral annulus, anterior, septal, lateral and inferior) were obtained. Mean peak systolic velocity (S wave), mean annular early diastolic velocity (e') by PW DTI and mean mitral annular displacement (MAD) by MME were calculated by averaging of values measured at each annular site. Results: MAD correlate well with LV EF, mean MAD < 11.275 mm determined by MME has 85% sensitivity and 87.8% specificity and 85.8% accuracy for detection of LV EF < 50%, Mad was low in patients with infarctions and lower in pationts with heart failure. Conclusion: Mean MAD connect with a positive relationship with LV EF and can detect the abnormal systolic motion on the long axis. That means the ability to detect the ischemia in early stages.