Restrictive pattern on Doppler transmitral flow pattern represent reduced left ventricular compliance and associated with poor prognosis in patients with systolic dysfunction due to congestive heart failure or myocaridal infarction. Although there are many clinical evaluation about clinical significance of restrictive transmitral flow pattern, investigation about what kinds of disease reveal the characteristic restrictive transmitral flow pattern and significance according to criteria of restrictive transmitral flow pattern is few. Therefore, we have analyzed patients with restrictive transmitral flow pattern in order to evaluate clinical diagnosis and clinical significance according to criteria of restrictive transmitral flow pattern.

The study population consisted of 229 patients(male 129 patients, female 102 patients, mean age 40.6 years old) who show E/A ratio p 2 on Doppler echocardiography from september 1994 to aprial 1996. We have reviewed the medical records of that patients.

1) In case of patients more than 2 at E/A ratio, we found that subjects not related with cardiovascular diseases were 76 persons(33.2%), valvular heart disease 75 patients(32.3%), ischemic heart disease 25 patients(10.9%), cardiomyopathy 16 patients(6.9%). Among valvular heart disease, mitral regurgitation was most frequently observed(44.5%). In these patients, patients with left ventricular systolic dysfunction were 60 patients(26.2%). 2) Patients more than 2 at E/A ratio and less than 150msec at deceleration time of E wave were 126 patients(55.0%). In these patients, we found that valvular heart disease was also most frequently observed(49 patients, 38.8%), subjects not related with cardiovascular diseases 30 persons(23.8%), cardiomyopathy 15 patients(11.9%),pericarditis 7 patients(5.6%), hypertension 3 patients(2-3%). Patients with left ventricular systolic dysfunction in this group were 39 patients(31.0%).

Although restrictive transmitral flow pattern on Doppler echocardiography represents reduced compliance of left ventricle or severe heart failure in patients with symptoms of congestive heart failure, this pattern also may be seen in persons not related with cardiovascular disease. Therefore, when making dicision about clinical significance of restrictive pattern, one should consider about any factors can influece the transmitral flow pattern and correlate the clinical diagnosis with mitral flow velocity.