Abstract： Objective To observe the changes of plasma ischemia-modified albumin (IMA) and left ventricular ejection fraction (LVEF)in old patients with cardiac dysfunction, and to explore the association between the IMA and left ventricular function. Methods Eighty-four cardiac dysfunction patients admitted to emergency room and ICU of Xuanwu hospital from April 2010 to June 2011 were enrolled. Eighty-four cases of patients were divided into three groups according to NYHA classification. They are NYHA Ⅱ , Ⅲ, Ⅳ. We recorded the patient's general condition,measured blood biochemical and the plasma IMA after admission, before discharge or illness worsened.Echocardiography was also examined. We studied the association between IMA and left ventricular ejection fraction (LVEF) values. Results IMA level of cardiac function class Ⅱ (45.24 ± 11.31 ) U/ml was lower than that of class Ⅲ (60.43 ± 10.73)U/ml and class Ⅳ(86.42 ± 12.25)U/ml (P＜0.05). The blood IMA, LVEF had statistical difference before and after treatment in recovering group and illness worsen/death group ( P ＜ 0. 05 ). Before treatment the blood IMA, LVEF between recovering group and death group had statistical significance and after treatment those also had statistical significance (P ＜ 0.05) between two groups. IMA has negative correlation with LVEF value(r= -0.619,P＜0.01). Conclusions The IMA concentrations in the plasma of patients with cardiac dysfunction increases with the heart function levels and declined the ejection fraction of left ventricular. IMA level significantly increases when patients are stable.