Diagnostic value of left ventricular diastolic function using pulsed Doppler echocardiography in patients with ischemic heart disease]

Transesophageal atrial pacing was performed in 54 patients (mean age 50.0 +/- 6.8 years) to diagnose coronary heart disease (CHD). ECG was recorded in 12 leads during the test. Echocardiography was used to assess local contractile disorders. The diastolic function of the left ventricle was examined by pulsed Doppler echocardiography in the postpacing period. Thirty eight patients were found to have altered Doppler parameters for transmitral blood flow in the postpacing period as compared to the resting period. Sixteen patients without CHD displayed no changes in the left ventricular diastolic function in the postpacing period. Two types of transmitral blood flow disorders were identified in CHD patients in the postpacing period. The so-called "pseudonormal" type of transmitral blood flow was typical of patients with the most severe contractile impairments and grave course. Abnormalities in local contractility and signs of left ventricular diastolic dysfunction were ascertained to be a sensitive marker for myocardial ischemia.