Clinical significance of early diastolic time intervals for the evaluation of left ventricular function in patients with coronary artery disease.

To investigate non-invasively the diagnostic significance of diastolic properties in coronary artery disease (CAD), the following early diastolic time intervals (EDTIs): IIA-O time (from the aortic component of the second heart sound to the O-point on the apexcardiogram), IIA-MVO time (from IIA to the mitral valve opening) and MVO-O time (from MVO to the O-point), were estimated in 18 patients with angina pectoris (AP) and 29 with old myocardial infarction (OMI) who were subdivided into two groups according to ejection fraction (EF): group I (OMI-I): more than 50% and group II (OMI-II): less than 50%. Seventeen patients without evidence of CAD were used as controls (N). Left ventricular pressure (LVP) and pulmonary capillary wedge pressure (PCWP) were measured simultaneously to clarify the relationship between EDTIs and early diastolic hemodynamics. IIA-O time and IIA-MVO time in AP, OMI-I and OMI-II were significantly longer than in N. This prolongation accorded with the reduction of left ventricular function. MVO-O time in AP and OMI-I also was significantly longer compared with that in N. In OMI-II, however, it was significantly shorter than in N. The prolongation of IIA-MVO time reflected impaired LV relaxation accompanied by LV dysfunction. The maintenance of low minimal LVP was the main contributor to the lengthening of MVO-O time in AP and OMI-I. Conversely, elevated minimal LVP and impaired LV relaxation resulted in the shortening of MVO-O time in OMI-II.(ABSTRACT TRUNCATED AT 250 WORDS)