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 flow velocities. Using this technique, 34 patients undergoing coronary angiography were prospectively studied, at rest and after 2 min of isometric handgrip exercise. Diastolic flow velocities at mitral valve, left 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 ratio was 1.48 +/- 0.95 at rest and 1.04 +/- 0.72 after exercise, the difference not being statistically significant. The E/A ratio of the left ventricular posterior wall was 1.66 +/- 0.55 at rest and 0.79 +/- 0.27 after exercise (p < 0.0001) and of the interventricular septum it was 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 diastolic dysfunction of the left ventricular posterior wall and interventricular septum.