EXTENT OF DIASTOLIC DYSFUNCTION CORRELATE D WITH SUBJECTIVE IMPAIRMENT OF PHYSICAL CAPACITY IN DILATED CARDIOMYOPATHY

Objective: To find out whether in patients with dilated cardiomyopathy (DCM) there is a correlation between subjective reduction in physical capacity and the transmitral Doppler profile as a measure of left ven tricular (LV) filling. Patients and methods: 30 consecutive patients ( 24 men, six women; average age 55 +/- 2 years) with chronic primary DC M were examined by Doppler echocardiography to determine possible diff erences in LV filling pattern, in correlation with subjective impairme nt of physical capacity graded according to the New York Heart Associa tion (NYHA) classification. Results: Mean LV ejection fraction was 34 +/- 1%. All patients were in sinus rhythm. Eight patients, in NYHA cla ss I had nearly normal LV filling (E wave 79 m/s, A wave 0.76 m/s); 11 patients in class II had impaired relaxation (E wave 0.77 m/s, A wave 0.82 m/s) and 11 in class III/IV had a restricted filling pattern (E wave 0.98 m/s, A wave 0.57 m/s). There was a significant difference be tween class II and class III/IV patients with regard to E wave deceler ation time (0.15 and 0.11s, respectively; P < 0.05), as well as betwee n class I and class III/IV patients (0.18 and 0.11 s, respectively; P < 0.05). The A wave deceleration time was clearly shorter in class III /IV than class 11 (0.08 s and 0.11s; P<0.05) and class I patients (0.0 8s and 0.10s; P < 0.05). Conclusions: The extent of LV diastolic dysfu nction correlated with subjective physical capacity. The more the LV f illing pattern had changed from normal towards restricted, the greater the patient's symptoms.