Echocardiographic study on diastolic posterior wall movement and left ventricular filling by disease category.

The diastolic characteristics of the left ventricle with special reference to the patterns of left ventricular filling and diastolic posterior wall movement were studied echocardiographically in 95 patients with various cardiac conditions including constrictive pericarditis, idiopathic cardiomyopathy (CCM, HCM), valvular aortic stenosis (AS), mitral stenosis (MS), hypertension (HT), aortic insufficiency (AI), mitral insufficiency (MI), and in 20 normal subjects. 1. Various types and severities of LV diastolic abnormalities were revealed by analyzing the patterns of posterior wall movement and LV filling in three diastolic phases--rapid filling period, slow filling period, and atrial filling period, respectively. 2. Disturbances of posterior wall distension and LV filling during the rapid filling period with a compensatory augmentation of atrial contribution to LV filling were observed in most patients. These patients also showed a markedly decreased posterior wall velocity and LV filling rate during rapid filling period. 3. E-F slope was significantly decrease in patients with MS, AS, and HCM. E-F slope correlated well with DPWV and RFR in most patients. In MS, however, DDR decreased to a disproportionate degree with a decrease in DPWV and RFR, probably due to the structural changes and decreased mobility of the mitral valve. From this study, we conclude that the patterns of the left ventricular filling and posterior wall movement during three phases of diastole obtained by echocardiography is useful in detecting left ventricular diastolic abnormalities.