Background: Global longitudinal strain (GLS) is more sensitive than ejection fraction (EF) in the diagnosis of preclinical LV systolic dysfunction (LVSD). Albuminuria is a predictor of symptomatic HF in patients with type 2 diabetes (DM2), but data on the relationship between GLS and albuminuria in DM2 are conflicting. Aim: To study the relationship between GLS and albuminuria in a contemporary cohort of DM2 patients. Materials and methods: The study was performed on DM2 patients consecutively enrolled in the TESEO study. We excluded patients with symptoms/signs of HF, EF<50%, cardiovascular diseases, other cardiac diseases, eGFR<30 ml/min/1.73m2, alcohol abuse, liver cirrhosis, and non-adequate acoustic window for GLS assessment. We collected clinical data, screened for complications, and measured GLS by speckle- tracking echocardiography. Logistic regression analysis was used to assess whether albuminuria was independently associated with LVSD-GLS (GLS>-18%). Results: Patients (n=156, age 60.2±7.8 years, 54.7% male) had a short DM2 duration (3.9±5.0 years) and good metabolic control (HbA1c 6.5%±1.1). Among them 14.7% had albuminuria and 24.4% subclinical LVSD-GLS. Systolic dysfunction was more frequent in patients with albuminuria (ACR≥3mg/mmol, 29.9% vs 10.2%, p=0.005) and GLS values were significantly higher in albuminuric patients (-17.94±2.88 vs -19.77±2.43, p<0.001) and correlated with ACR (r=0.246, p=0.002), systolic (r=0.186, p=0.02) and diastolic (r=0.189, p=0.018) blood pressure, triglycerides (log-TG, r=0.237, p=0.003), and HDL- cholesterol (HDL-c, r=-0.186, p=0.02). In logistic regression analysis, albuminuria was associated with a 4.6 (95%CI 1.5-13.5) increased OR of LVSD-GLS, independent of age, gender, log-TG, HDL-c, blood pressure, eGFR, e’ lateral. Albuminuria was the only variable associated with LVSD-GLS after stepwise selection. Conclusions: This study demonstrated that albuminuria is independently associated with subclinical left ventricular systolic dysfunction in asymptomatic DM2 patients.