Diastolic function can be assessed by Doppler-derived left ventricular(LV) filling patterns. E/A ratio<1 and prolongation of isovolumic relaxation time(IVRT) are diagnostic of impaired relaxation of left ventricle during diastole. In early stage of acute myocardial infarction, myocardial stiffness can normalize the E/A ratio and mask the Doppler indexes of abnormal relaxation in patients with acute myocardial infarction.

LV filling patterns were studied with Doppler echocardiography in 10 healthy subjects and 27 patients with recent acute myocardial infarction. Cardiac catherterization was performed in the 11±2 days after onset of acute myocardial infarction and left ventricular end-diastolic pressure(LVEDP) and myocardial stiffiness index(MSI) were studied.

In patients with acute myocardial infarction, IVRT was significantly prolonged ; E/A ratio and deceleration time were decreased but not significantly different from those of normal subjects. In the patient's group of E/A>1,IVRT and atrial filling fraction(AFF) were significantly shortened, and LVEDP was significantly increased, compared to those of the patient's group of E/A<1. But ejection fraction was similar in both groups. In the patients with acute myocardial infarction, E/A ratio and LVEDP showed good correlation(r=0.64, p<0.05). MSI was increased in the patient's group of E/A>1 and also was well correlated with LVEDP(r=0.8, p<0.05).

Thus we conclude that normal of increased E/A ratio in recent acute myocardial infarction may reflect increased LVEDP due to increased myocardial stiffness.