REGIONAL LEFT-VENTRICULAR DIASTOLIC FUNCTION IN ISCHEMIC-HEART-DISEASE - A PULSED DOPPLER ECHOCARDIOGRAPHIC EVALUATION

Pulsed Doppler echocardiography has been shown to be useful for direct analysis of the left ventricular regional instantaneous diastolic flo w velocities. Using this technique, 34 patients undergoing coronary an giography were prospectively studied, at rest and after 2 min of isome tric handgrip exercise. Diastolic flow velocities at mitral valve, lef t ventricular posterior wall and interventricular septum were analyzed and E/A ratio calculated. There were significant differences in peak E velocity, peak A velocity and E/A ratio among controls and patients, both at rest and after exercise. In the patient group, mitral E/A rat io was 1.48 +/- 0.95 at rest and 1.04 +/- 0.72 after exercise, the dif ference not being statistically significant. The E/A ratio of the left ventricular posterior wall was 1.66 +/- 0.55 at rest and 0.79 +/- 0.2 7 after exercise (p < 0.0001) and of the interventricular septum it wa s 1.23 +/- 0.43 at rest and 0.76 +/- 0.22 (p < 0.001) after exercise. Thus, this study shows that patients with significant coronary artery disease have an altered global and regional left ventricular diastolic function at rest. Isometric handgrip exercise induced further diastol ic dysfunction of the left ventricular posterior wall and interventric ular septum.