Effects of posture on left ventricular diastolic filling during exercise

Background: Measuring the transmitral flow velocity with Doppler echocardio graphy is a useful method for evaluating left ventricular diastolic functio n. However, there are few data regarding the effect of posture during exerc ise on transmitral flow velocity. Methods: The transmitral flow velocity wi th pulsed-wave Doppler echocardiography was measured during supine and upri ght bicycle ergometer exercise in 10 normal young men without cardiac disea se (26.7 +/- 5.5 yr). Results: The ratio of the early rapid filling wave to the atrial filling wave (E/A) was gradually decreased with increasing exer cise intensity. At rest and during recovery, the E/A ratio was significantl y higher (P < 0.01) in the supine position than in the upright position. Th is difference was caused mainly by the higher E wave in the supine position . However, E wave and E/A ratio did not differ between the upright and supi ne position during exercise. Conclusion: Although measurement of left ventr icular filling is completely noninvasive and clinically useful for evaluati ng diastolic function, it was found that the E/A ratio was profoundly influ enced by posture and exercise intensity. These results suggest that the pot ential influences of posture and exercise intensity on the filling velociti es should be taken into account when interpreting diastolic function by Dop pler echocardiography.