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Purpose: Similar grade el the lell ventricular (LV) syslolic injury can coexisl wilh diflerenl grade of diastolic dysfunction. Patients wilh reslriclive inflow pallern have more severe dysfunction than those wilh impaired relaxalion. Myocardial pedormance index (MPI) (Tel inde(), and flow propagation velocily (Prop) are helplul in LV global lunction estimation, but their uselulness in diflerenl types of diastolic dyslunction is not well recognized. Methods: We studied 71 pts with ischemic hearl disease or primary dilaled cardiomyopathy, with LV ejection lraclion (EF) <45%, on sinus rhythm, and wilhoul valvular disease. In 41 pls there was impaired LV relaxalion (E/A ralio<0,7), (group REL), and in 30 reslrictive inflow pattern (E/A ralio>2,0), (group RES). We assessed: LV endsyslolic and enddiastolic dimensions, lelt alrial (LA) dimension, LV EF, velocily el mitral E and A waves and E/A ratio, E wave deseleralion lime, and Prop. MPI and Prop/E ralio was calculated. Results: Mean age, body sudace and heart rate in assessed groups were comparable. In RES there were higher dimensions el LV in diastole (6,94-1,1 cm vs 6,44-0,8 cm; p<0,05) and in systole (5,74-1,1 cm vs 5,04-0,9cm; p<0,01) and LA (4,84-0,5 cm vs 4,24-0,6cm; p<0,02), than in REL. In RES EF was lower than in REL (26,34-7,2% vs 35,54-8,2%; p<0,001). E,'Prop ratio was higher in RES (2,64-0,6) than in REL (1,64-0,5); p<0,0001. Paradoxically, MPI was higher in REL (0,724-0,2 vs 0,624-0,2; p<0,05) and Prop in RES (38,44-7,5cm/s, in REL 30,44-9,7cm/s; p<0,001). In REL we observed significant correlations between: Prop and EF (r=0,55), MPI and EF (r= -0,43), Prop and E/A (r=0,58), and Prop and MPI (r= -0,44). In RES there were no significant correlations between eslimaled paramelers. Conclusion: Myocardial performance index and flow propagation velocity is more useful in global LV function assessmenl in patients with mild diastolic dyslunction than in those wilh restriclive inflow patlern. The reason can be more complex mechanism of severe diastolic dysfunction.

european journal of echocardiography

876 Myocardial performance index and flow propagation velocity in left ventricular function assessment in patients with low ejection fraction and different types of diastolic dysfunction