彩色多普勒超声心动图评价扩张型心肌病左心室舒张功能

目的　用彩色多普勒超声探讨扩张型心肌病患者左心室舒张功能的改变。方法　利用彩色多普勒超声心动图将 37例扩张型心肌病患者分为合并二尖瓣反流组及无二尖瓣反流组 ,观察其二尖瓣及肺静脉血流频谱并与正常人对照。结果　扩张型心肌病无二尖瓣反流组中仅有 41.2 %患者二尖瓣血流频谱 E/ A小于 1,其余均表现为 E/A大于 1,甚至 E/ A大于 2。扩张型心肌病合并二尖瓣反流组 E/ A均大于 2。而扩张型心肌病患者肺静脉血流频谱 ,与正常人组比较有明显差异 ,S峰均明显降低 ,D峰 >S峰 ,结论　扩张型心肌病在收缩功能减退同时有舒张功能异常 ,二尖瓣血流频谱可出现“假性正常化”,掩盖其左心室舒张功能的异常 ,应用肺静脉血流频谱有助于识别二尖瓣血流频谱“假性正常化”,但在评价扩张型心肌病合并二尖瓣反流患者左心室舒张功能时有其局限性     

肺静脉多普勒血流频谱评价永久人工VVI心脏起搏器对左心室舒张功能的影响

目的探讨应用多普勒超声心动图标测肺静脉血流频谱及二尖瓣血流频谱的变化,无创评价永久人工VVI心脏起搏器植入前后左心室舒张功能的价值。方法对24例患者在永久人工VVI心脏起搏器植入前和植入后2个月进行多普勒超声心动图测量肺静脉收缩期最大流速(S)、S波的速度-时间积分(Svti)、舒张早期最大流速(D)、D波的速度时间积分(Dvti)、Svti/(SDvti+Svti)为收缩分数(SF)、心房收缩反向A波的最大速度(PA)、PA波间期(PAd);二尖瓣E峰最大速度(E)、A峰最大速度(A)、E/A比值。结果永久人工VVI心脏起搏器术后2个月时S、Svti较术前显著下降(P<0.05);Dvti、PA、PAd较术前显著升高(P<0.05);但D术后2个月较术前无显著变化(P>0.05)。永久人工VVI心脏起搏器植入术后2个月时E、E/A较术前显著下降(P<0.05);A较术前显著升高(P<0.05)。结论永久人工VVI心脏起搏器植入术后,左心室舒张功能减退。肺静脉血流频谱结合二尖瓣血流频谱可以准确的反映左心室舒张功能。     

M型彩色多普勒超声心动图对原发性高血压和冠心病患者左室舒张功能的研究

目的用M型彩色多普勒超声心动图研究原发性高血压(EH)和冠心病(CAD)的左室舒张功能,并与传统方法比较.方法用M型彩色多普勒超声心动图,研究了36例正常人(Ⅰ组),74例原发性高血压患者(Ⅱ组)和33例冠心病患者(Ⅲ组).测定左室舒张早期、晚期跨二尖瓣血流峰速(E峰和A峰)、早晚期血流峰速比(E/A)和舒张晚期跨二尖瓣血流峰速时间(AD);同时测定肺静脉收缩期血流速度(S)、舒张期血流速度(D)、肺静脉返流速度(Pva)和返流时间(Pvad).采用M型彩色多普勒超声心动图测定了从二尖瓣到心尖的早期充盈峰速传播速率(Vp),早期充盈峰速时间(TD)和Vp/E比值.结果三组在性别、年龄和心率方面无统计学差异.根据EF值将患者分成EF≤60%组(收缩功能障碍组)和EF＞60%组(收缩功能正常组).收缩功能障碍组与收缩功能正常组的所有传统舒张功能参数无显著性差异,但两组在Vp、TD和Vp/E差异有统计学意义.对10例收缩功能障碍患者(EF≤60%)而E/A值正常(＞ 1)(假性正常化)的研究结果显示,在假性正常化组和对照组Vp、T)和Vp/E有显著性差异(P＜0.01).而其他舒张功能参数差异无显著性.结论①原发性高血压和冠心病患者存在舒张功能障碍.②M型彩色多普勒超声心动图测定的早期充盈峰速传播速率和时间(vp、TD和Vp/E)是评价左室舒张功能更精确和更可靠的参数,它们可以区别假性正常化的跨二尖瓣血流类型.     

脉冲多普勒检测肺静脉及二尖瓣血流的临床意义评价

左心室舒张功能异常,是评价早期心肌缺血的一项敏感指标。近年来将二尖瓣血流频谱分析研究,作为评价左室功能常用指标的报道较多,与肺静脉血流频谱同时进行对照研究则鲜见报道。我们应用彩色多普勒超声心动图检测了3组共150例右上肺静脉血流频谱,与二尖瓣血流进行对比分析,旨在讨论二尖瓣与肺静脉血流频谱评价左室舒张功能的临床意义,报告如下。     

冠心病患者PTCA及支架植入术后左心室舒张功能变化的随访观察

目的　研究经皮腔内冠状动脉成形术 (PTCA)及支架植入术对冠心病患者左心室舒张功能变化的影响。方法　收集心绞痛患者 3 8例和心肌梗死患者 3 6例 ,应用超声心动图检测 PTCA及支架植入术术前及术后 1年左心室舒张功能指标 ,包括二尖瓣和肺静脉血流频谱以及等容舒张时间 (IRT) ,并与对照组比较。结果　治疗前心绞痛组与心肌梗死组均存在二尖瓣和肺静脉血流频谱异常 ,IRT显著延长 ,两组间有显著差异。治疗 1年后两组二尖瓣和肺静脉血流频谱各有部分指标显著改善 ,IRT显著缩短 ;但两组部分指标差异仍有显著性。结论　 PTCA及支架植入术可改善冠心病患者远期左心室舒张功能 ,但心绞痛与心肌梗死患者比较左心室舒张功能仍有显著差别     

慢性心力衰竭的左心室舒张功能检测

目的探讨舒张性心力衰竭(心衰)与收缩性心衰的超声特点。方法选择舒张性心衰患者40例为舒张性心衰组,并选择基本情况与之匹配的收缩性心衰患者40例为收缩性心衰组。应用多普勒技术进行舒张功能的检测,进而评价2组在心房、心室容积,二尖瓣口血流舒张早期流速(E)与二尖瓣口血流舒张晚期流速(A)及其比值(E/A)和E峰减速时间,二尖瓣环舒张早期峰值速度(e)和二尖瓣环舒张晚期峰值速度(a)及其比值(e/a),左心房反流入肺静脉血流速度,P波终末电势等方面的差异。结果舒张性心衰组与收缩性心衰组比较,E/A、e/a倒置。舒张性心衰组E峰减速时间延长,左心房反流入肺静脉血流速度增宽。舒张性心衰组左心房增大,左心室舒张末径正常。P波终末电势负值增大。结论肺静脉血流频谱和二尖瓣环组织多普勒可作为二尖瓣血流频谱重要补充。     

多普勒超声心动图对左室舒张功能的评价

目的：应用多普勒超声心动图二尖瓣口血流频谱舒张期充盈速度、容积时间指标，评价心脏左室舒张功能。方法：对68例高血压、冠心病住院病例进行多普勒超声心动图二尖瓣口血流频谱检测和分析。结果：46例高血压病例中42例（占91．8％）、冠心病22例中20例（占90．91％）表现为等容舒张期延长，时间大于110ms,E峰降低、A峰增高，E／A比值小于1。结论：二尖瓣口血流频谱E峰与A峰比值能反映左室舒张功能情况。高血压、冠心病人大部分有左室舒张功能障碍。     

氨基末端B型脑钠肽前体与非梗阻性肥厚型心肌病患者左心室舒张功能的相关性研究

目的探讨血浆氨基末端B型脑钠肽前体(NT-proBNP)水平与非梗阻性肥厚型心肌病(HNCM)患者左心室舒张功能的关系。方法选择46例HNCM患者,20名健康体检者作为对照组,电化学发光法检测两组血浆NT-proBNP水平,超声心动图、组织多普勒显像(TDI)检测室间隔厚度、射血分数和反映左心室舒张功能的参数。结果HNCM组患者平均NT-proBNP血浆水平明显高于对照组(P<0.001);NT-proBNP血浆水平与以下左心室舒张功能参数均呈正相关:二尖瓣室间隔侧舒张早期最大运动速度e(r=0.74,P<0.001)、e与二尖瓣室间隔侧舒张晚期最大运动速度a比值e/a(r=0.69,P<0.001)、心房收缩开始至左室流出道内心室收缩期前流速开始的间期A-Ar(r=0.63,P=0.029)、Tei指数(r=0.63,P<0.001)、肺静脉频谱收缩期肺静脉血流速度S与舒张期肺静脉血流速度D的比值S/D(r=0.62,P<0.001)、等容舒张时间(IVRT)(r=0.56,P<0.001)、二尖瓣血流频谱舒张早期充盈峰值速度E(r=0.54,P<0.001)、a(r=0.53,P<0.001)、二尖瓣血流频谱舒张晚期充盈峰值流速A(r=0.36,P=0.02)、E/A(r=0.47,P<0.001)。多因素Logistic回归分析显示,e/a、S/D是NT-proBNP血浆水平的独立影响因素。结论NT-proBNP血浆水平与超声心动图左心室舒张功能参数间存在明显的正相关性,可以作为评价HNCM患者左心室舒张功能不全的客观指标。     

伴或不伴糖尿病的肥胖患者左室舒张功能不全发生率比较

迄今,关于肥胖是否将导致左心室(LV)舒张功能不全尚不清楚,但糖尿病无疑与LV舒张功能受损有关。现就伴与不伴糖尿病的肥胖患者相关LV舒张功能不全发生率的可能差异进行了比较。133例肥胖对象,男22例,女111例。其中40例伴有糖尿病,93例不伴糖尿病。研究中均接受多普勒超声心动图检测,若超声测得舒张早期跨二尖瓣血流峰速(E)/舒张晚期跨二尖瓣血流峰速(A)比值为0.75~1.50,并同伴下列之一者:E/舒张早期心肌血流峰速(Ea)≥10,或收缩期肺静脉血流峰速(S)/舒张期肺静脉血流峰速(D)<1.0,视为中度LV舒张功能不全;若同伴E/A>1.5视为伴重度LV…     

多普勒超声心动图4种检测方法评价左室舒张功能

目的　应用二尖瓣血流频谱、肺静脉血流频谱、彩色M型多普勒超声心动图 (CMM)和组织多普勒图像 (DTI)等 4种方法评价左室舒张功能 ,并对其结果进行比较。　 方法　使用 4种多普勒超声心动图方法测定的相应数值评价正常组 (3 0例 )、高血压组 (3 0例 )及心肌梗死组 (2 7例 )的左室舒张功能的情况。　 结果　 (1)二尖瓣血流频谱表明高血压组左室舒张功能异常表现为松弛减退 (E/A <1) ;(2 )心肌梗死组E/A值与正常组比较无明显差异 ,肺静脉舒张末逆流峰值 (AR)明显增大 ,CMM测定的舒张早期血流传导速度 (FPV)明显减小 ,DTI测定的负向舒张早期波 (Ea)及Ea与负向舒张晚期波 (Aa)的比值 (Ea/Aa)与其他 2组比较P均 <0 0 1。　 结论 　评价左室舒张功能异常时 ,二尖瓣血流频谱能及早发现松弛减退 ,在可能存在假性正常时 ,综合应用AR、FPV、Ea、Ea/Aa可予以识别。考虑到经胸途径检查肺静脉往往比较困难且费时较多 ,而FPV、Ea、Ea/Aa测定简便易行 ,是综合评价左室舒张功能的有用指标。     

Acute effects of cigarette smoking on left ventricular diastolic function.

Cigarette smoking increases coronary resistance in patients with coronary artery disease, causing profound disturbances in myocardial perfusion. The acute effects of smoking a single cigarette on left ventricular diastolic function were studied in 20 smokers with typical angina pectoris and angiographically documented coronary artery disease. Twenty healthy smokers served as a control group. We used simultaneous M-mode echocardiography of the mitral and aortic valves to measure isovolumic relaxation time, and pulsed Doppler echocardiography of transmitral blood flow was recorded to evaluate left ventricular filling before and immediately after smoking. In the patients with coronary artery disease, systemic blood pressure and heart rate significantly increased after smoking. The isovolumic relaxation time, the deceleration time as well as peak A velocity remained unchanged. The peak E velocity decreased by 0.06 m.s-1 (P = 0.02) and the peak E/A velocity ratio by 0.17 m.s-1 (P = 0.01). There were no significant changes in left ventricular diastolic function indexes in the controls. These results indicate that in patients with coronary artery disease, each cigarette provokes disturbances of left ventricular diastolic function.     

Longitudinal myocardial dysfunction in healthy older subjects as a manifestation of cardiac ageing

BACKGROUND: Abnormalities of longitudinal left ventricular (LV) contraction and relaxation may be early markers of cardiac disease. This study was designed to assess the relationship between long-axis LV function and age in healthy subjects. METHODS: 118 healthy individuals aged 57 +/-19 years (range 20-90 years) with no evidence of cardiovascular disease under-went echocardiography with Doppler examination of transmitral flow. To assess longitudinal LV function, systolic (S(m)), early diastolic (E(m)) and late diastolic (A(m)) mitral annular velocities were measured using colour-coded tissue Doppler imaging. RESULTS: The left atrium was enlarged (P<0.001) in subjects >/=60 years of age compared to those <60 years, but there were no differences in LV volumetric indices and ejection fraction. Peak E velocity was lower (P<0.001) and peak A velocity of transmitral flow was higher in older subjects (P<0.001) with a higher E/A ratio (P<0.001) and longer isovolumic relaxation time (P= 0.001) indicative of impaired ventricular relaxation. S m and E m mitral annular velocities decreased (P<0.001) and A m velocity increased (P=0.002) in the older group. E m velocity and E m /A m ratio showed a strong negative correlation with age (r= -0.80, P<0.001 and r=-0.78, P<0.001, respectively). CONCLUSIONS: Global LV systolic function is preserved but the velocity of long-axis systolic shortening is depressed in older individuals, indicating selective impairment of the longitudinal component of systolic contraction. The decline in the velocity of early diastolic long-axis LV lengthening and the changes in the pattern of transmitral flow suggest impaired ventricular relaxation. These measures of cardiac function may be a useful index of normal cardiac ageing.     

Left ventricular diastolic dysfunction in patients with COPD in the presence and absence of elevated pulmonary arterial pressure

BACKGROUND: Increased right ventricular afterload leads to left ventricular diastolic dysfunction due to ventricular interdependence. Increased right ventricular afterload is frequently present in patients with COPD. The purpose of this study was to determine whether left ventricular diastolic dysfunction could be detected in COPD patients with normal or elevated pulmonary artery pressure (PAP). METHODS: Twenty-two patients with COPD and 22 matched control subjects underwent pulsed Doppler echocardiography. Left ventricular systolic dysfunction and other causes of left ventricular diastolic dysfunction (eg, coronary artery disease) were excluded in all patients and control subjects. PAP was measured invasively in 13 patients with COPD. RESULTS: The maximal atrial filling velocity was increased and the early filling velocity was decreased in patients with COPD compared to control subjects. The early flow velocity peak/late flow velocity peak (E/A) ratio was markedly decreased in patients with COPD compared to control subjects (0.79 +/- 0.035 vs 1.38 +/- 0.069, respectively; p < 0.0001), indicating the presence of left ventricular diastolic dysfunction. The atrial contribution to total left diastolic filling was increased in patients with COPD. This was also observed in COPD patients with normal PAP, as ascertained using a right heart catheter. The atrial contribution to total left diastolic filling was further increased in COPD patients with PAP. PAP correlated with the E/A ratio (r = -0.85; p < 0.0001). CONCLUSIONS: Left ventricular diastolic dysfunction is present in COPD patients with normal PAP and increases with right ventricular afterload.     

冠心病患者冠状动脉狭窄程度与循环B型利钠肽水平的关系

目的探讨冠心病患者冠状动脉狭窄与循环B型利钠肽(BNP)水平的相关性。方法选取冠心病患者85例作为冠心病组,同期无血管病变者46例作为对照组。采用Gensini评分系统评定冠状动脉狭窄程度,心脏超声测定左心室舒张未内径(LVDd)、左心室舒张末期容积(LVEDV)、LVEF、二尖瓣舒张早期运动速度(E)及舒张晚期运动速度(A),并计算E/A比值。用放射免疫法测定BNP浓度。结果冠心病组心功能(NYHA)Ⅲ级患者的E A值较Ⅰ、Ⅱ级降低,血清BNP水平较Ⅰ、Ⅱ级增加,血清BNP水平与E/A呈负相关(r=-0.61,P<0.05);冠心病组心功能Ⅲ级患者LVEDV、BNP水平较对照组显著升高(P<0.05),血清BNP与LVEDV呈正相关(r=0.65.P<0.05)。冠心病组LVEF较对照组明显减低(P<0.05),血清BNP较对照组升高(P<0.01)。Gensini积分与血清BNP水平呈正相关(r=0.851,P<0.01)。结论冠心痛患者血清BNP水平升高除与心功能不全相关外,心肌缺血亦可影响BNP分泌,导致循环BNP升高。     

应用多普勒组织成像评价冠心病患者左心室舒张功能

目的 :探讨应用多普勒组织成像 （DTI）检测二尖瓣环运动速度评估冠心病左室舒张功能的临床应用价值。方法 :应用 DTI技术 ,对 5 3例冠心病患者和 48例正常对照者二尖瓣环运动速度进行测定 ,并与常规多普勒超声心动图检查结果对照分析。结果 :与正常组相比 ,冠心病患者舒张早期 DTI速度峰值 （Ve）显著减低 （P<0 .0 1） ,舒张早期与舒张晚期 DTI速度峰值的比值 （Ve/ Va）显著减低 （P<0 .0 5 ）。冠心病患者 Ve/ Va比值异常检出率显著高于二尖瓣血流 E/ A比值的异常检出率 （P<0 .0 5 ）。 Ve/ Va比值与 E/ A比值之间存在高度相关性 （P<0 .0 1）。结论 :DTI技术检测二尖瓣环舒张期运动速度参数可用于无创评价冠心病左室舒张功能 ,尤其对鉴别伪正常具有一定应用价值。     

Doppler assessment of left ventricular diastolic filling during brief coronary occlusion

To assess left ventricular diastolic filling in patients with single-vessel coronary artery disease, Doppler-derived transmitral velocity was studied in 22 normal subjects and in 15 patients with isolated proximal stenosis of the left anterior descending coronary artery (LAD) and normal systolic function of the left ventricle. Transmitral velocity was recorded before and after balloon inflation during coronary angioplasty. At baseline the transmitral velocity pattern in patients with LAD stenosis differed from that of normal subjects with a significant (p at least less than 0.05) decrease in the early diastolic filling phase (E area 0.094 +/- 0.022 m in normal subjects vs 0.078 +/- 0.008 m in patients) and an increase in the late diastolic filling phase (A area 0.034 +/- 0.007 m vs 0.042 +/- 0.008 m). Correspondingly the ratio E area/A area decreased (2.7 +/- 0.51 vs 1.9 +/- 0.4) and the ratio A area/total area increased (0.28 +/- 0.04 vs 0.35 +/- 0.05). During coronary occlusion the E area and the ratio E area/A area decreased further, whereas the A area and the ratio A area/total area increased. The results suggest that patients with single-vessel disease and normal systolic function often exhibit an altered pattern of transmitral velocity even in the absence of overt ischemia, and that during acute regional ischemia early diastolic filling is further compromised with compensatory enhancement of the late diastolic filling phase.     

Preload reduction with right ventricular pacing: Effects on left ventricular hemodynamics and contractile pattern

Studies were performed in 32 patients to evaluate left ventricular pressure-volume changes and contractile pattern during right ventricular pacing as compared to normal sinus rhythm. Coronary artery disease was present in 27 patients, while 5 patients (control group) had no evidence of coronary artery or left ventricular disease. Studies were performed during both normal sinus rhythm and right ventricular pacing at comparable heart rates, utilizing angiographic methods to determine heart volumes. Right ventricular pacing in all patients resulted in decreased left ventricular systolic (p< 0.01) and diastolic (p< 0.01) pressures and decreased stroke work (p< 0.001). In the control group, right ventricular pacing caused a decrease in left ventricular end-diastolic volume (p< 0.01) and stroke volume (p< 0.01), with no change in ejection fraction. The patients with coronary artery disease were divided into four groups, dependent on the left ventricular contractile pattern during normal sinus rhythm and the percentage of change in hemiaxis shortening during right ventricular pacing. In group A (six patients with asynergy) and group B (seven patients with asynergy), there was no significant change in the percentage of hemiaxis shortening during right ventricular pacing when compared to normal sinus rhythm. Ventricular volume studies in these patients (groups A and B) were similar to the control groups and no change in contractile pattern was observed during pacing. In group C, twelve patients had asynergy and a 10% increase in percentage of hemiaxis shortening during right ventricular pacing when compared to normal sinus rhythm. Right ventricular pacing resulted in decreased end-diastolic pressure (p< 0.01) and end-diastolic volume (p< 0.001), no change in stroke volume, and an increased ejection fraction (p< 0.01). Contractile patterns improved in all patients in group C during pacing. Group D consisted of two patients with asynergy and a 10% decrease in percentage of hemiaxis shortening during pacing, associated with a decrease in end-diastolic volume and ejection fraction with deterioration of left ventricular contractile pattern. These results indicate that right ventricular pacing in patients with coronary artery disease decreases preload, which may be accompanied by improved left ventricular contractile pattern (11/27) and in some patients (2/27) deterioration of left ventricular function.     

组织多普勒超声评价冠状动脉狭窄患者左心室舒张功能

目的探讨组织多普勒超声评价冠状动脉不同狭窄程度对左心室舒张功能的影响。方法在我院行冠状动脉造影检查的患者219例,根据造影结果分为3组,冠状动脉病变严重组(至少1支血管狭窄≥70%,A组),冠状动脉病变轻微组(血管狭窄70%,B组)和冠状动脉造影检查正常组(C组)。应用超声测量冠心病患者二尖瓣舒张早期血流峰值(E)与组织多普勒成像二尖瓣环舒张早期峰值(Em)的比值(E/Em)。结果 A组的E/Em较B、C组高,差异有统计学意义(P0.05,P0.01),B组与C组比较,E/Em差异无统计学意义(P0.05)。结论E/Em可检测出冠状动脉高度狭窄引起的左心室功能障碍。     

Use of Valsalva maneuver to unmask left ventricular diastolic function abnormalities by Doppler echocardiography in patients with coronary artery disease or systemic hypertension

It has been suggested that changes in left atrial pressure may mask or mimic left ventricular diastolic function abnormalities detected by Doppler echocardiography. The effect of the Valsalva maneuver on the transmitral flow velocity profile was therefore studied in 28 patients without evidence of coronary artery disease (group 1, mean age +/- standard deviation 50 +/- 8 years) and in 94 patients with evidence of coronary artery disease or systemic hypertension (group 2, mean age 54 +/- 10 years). At baseline, group 2 patients had higher peak late diastolic filling velocity (A), lower peak early (E) to late diastolic filling velocity (E/A) ratio and longer isovolumic relaxation time than group 1, whereas heart rate, E velocity and E deceleration time were similar in both groups. During Valsalva, both groups had similar increases in heart rate and similar decreases in E velocity but E/A ratio decreased significantly only in group 2 because of a lesser decrease in A velocity. The E/A ratio was greater than or equal to 1.0 both before and during Valsalva in all but 1 patient in group 1, whereas in group 2, 32 patients had E/A greater than or equal to 1.0 at rest and during Valsalva, 33 patients had E/A greater than or equal to 1.0 at rest but less than 1.0 both at rest and during Valsalva. Using group 1 as controls, prevalence, specificity and positive predictive value of E/A less than 1.0 in group 2 were 31, 100 and 100% at rest and 66, 96 and 98% during Valsalva.(ABSTRACT TRUNCATED AT 250 WORDS)     

The prevalence of impaired left ventricular diastolic filling is related to the extent of coronary atherosclerosis in patients with stable coronary artery disease

AIMS: The relation between abnormal left ventricular (LV) diastolic filling and the extent of coronary atherosclerosis per se has not been described. We aimed to investigate the prevalence of impaired LV diastolic filling in patients with stable coronary artery disease (CAD) and its relationship to the number and location of coronary lesions visualized at coronary angiography. METHODS AND RESULTS: In 170 consecutive patients with stable CAD and an abnormal coronary angiogram we assessed LV diastolic filling by Doppler evaluation of the transmitral early to atrial peak flow velocity (E/A) and the systolic to diastolic ratio of the pulmonary venous peak inflow to the left atrium (S/D). Abnormal diastolic filling was defined as E/A < or =0.75, or E/A >1.0 combined with S/D < or =1.0, and was present in 41% of the patients. In patients with one-, two- and three-vessel disease the prevalence of impaired diastolic filling was 27, 30 and 49%, respectively (P = 0.026). In multiple logistic regression analysis diastolic filling was independently correlated with the number of stenotic coronary vessel areas. CONCLUSION: In patients with stable angiographically verified CAD, the prevalence of impaired diastolic filling was 41%. The prevalence increased with an increasing number of stenotic coronary artery areas independent of other variables tested, including prior myocardial infarction, LV systolic function and mitral regurgitation.