Heart failure risk factors research as well as studies of myocardial dysfunction to identify subclinical heart disease are important problems that can be solved with stress echocardiography and new methods of myocardial function analysis. Key factors defining the prognosis of patients with valvular diseases are heart remodeling and myocardial contractility. Heart remodeling types have been studied in detail by the present time. Elucidation of capability of stress echocardiography to detect asymptomatic dysfunction and assess prognosis of the results of surgery is continuing. Most important technological achievements of the last ten years gave us the opportunity to quantitatively assess myocardial function and movement. Tissue Doppler and Speckle Tracking enabled us to find alternative to invasive methods way to determination of parameters of global and regional myocardial function. Nowadays the first research results on the use of Speckle Tracking to estimate the contractile reserve are appearing. A high prognostic significance of global longitudinal deformation has been revealed. The aim of this article is to summarize available data on assessment of severity of valvular heart disease and the state of myocardial contractile reserve using stress echocardiography, Tissue Doppler and Speckle tracking data.