Objective: To evaluate the alteration of left ventricular long-axis systolic function during left ventricular geometric remodeling in essential hypertension(EH) using real-time triplane quantitative tissue velocity imaging and to investigate its clinical significance. Methods: Totally 101 patients with EH and 31 healthy volunteers were enrolled. Systolic peak velocity(Vs) was measured at basal and middle segments in different left ventricular walls using real-time triplane quantitative tissue velocity imaging. Results: Based on Ganau, patients with EH were divided into 4 groups: normal geometry(32 cases), concentric remodeling(22 cases), concentric hypertrophy(28 cases) and eccentric hypertrophy(19 cases). Vs in each hypertensive groups were significantly lower than in control groups(P<0.05, 0.01). There was a significantly step-down change among normal geometry, concentric remodeling, concentric hypertrophy and eccentric hypertrophy groups in Vs(P<0.05, 0.01). Conclusions: Real-time triplane quantitative tissue velocity imaging can assess left ventricular long-axis systolic function correctly in patients with EH and its alteration during left ventricular geometric remodeling.