title: Effects of Left Ventricular Wall Motion Abnormality on Global and Regional Diastolic Function of the Left and Right Ventricles at Rest and After Stress.
abstract: BACKGROUND
  Diastolic dysfunction precedes systolic dysfunction in patients with coronary artery disease. The aim of the study was to evaluate the effects of left ventricular (LV) wall motion abnormality (WMA) on diastolic LV and right ventricular (RV) function at rest and after stress.
  
  
  METHODS
  Fifty-nine subjects, 15 with LV-WMA (abnormal group) and 44 without (normal group), underwent dobutamine stress echocardiography (DSE) studies, in addition to evaluation of LV and RV diastolic function before and after DSE.
  
  
  RESULTS
  Resting mitral flow parameters were similar. DSE increased peak A-wave velocities in both groups, and mitral color slope only in normal subjects. After DSE, E-wave peak velocities and mitral color slope were higher in normal subjects, P < 0.05. At rest and after DSE systolic and diastolic pulmonary vein velocities were similar in both groups; however, DSE increased these velocities only in normal subjects, P < 0.05. Regional E-wave peak velocities of LV were higher at rest in normal subjects, P < 0.05. Both LV and RV, regional peak E-wave velocities were not affected by DSE. After DSE, regional A-wave peak velocities increased in all (P < 0.01), except at the lateral region (P = 0.07). DSE increased trans-tricuspid velocities in both groups, P < 0.05. Resting A-wave velocities were higher in normal subjects, P < 0.01.
  
  
  CONCLUSIONS
  Global LV early diastolic filling parameters were not affected by LV-WMA at rest. LV-WMA blunted the response after stress. RV E-wave velocities increased after DSE, and were not affected by LV-WMA. LV-WMA reduced regional LV-E' velocities at rest but not the reserve. A-wave velocities were not affected by WMA and increased after DSE.
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel; Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Dawod
authors.initials: D
authors.lastname: Sharif
authors.affiliation: Technion - Israel Institute of Technology, Haifa, Israel; Mathematics Department, The Academic Arab College, Haifa, Israel.
authors.forename: Amal
authors.initials: A
authors.lastname: Sharif-Rasslan
authors.affiliation: Technion - Israel Institute of Technology, Haifa, Israel; Department of Internal Medicine A, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Majed
authors.initials: M
authors.lastname: Odeh
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Camilia
authors.initials: C
authors.lastname: Shahla
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel.
authors.forename: Amin
authors.initials: A
authors.lastname: Khalil
authors.affiliation: Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel; Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Rosenschien
keywords: Diastolic function; Dobutamine stress echocardiography; Ischemia; Left ventricle; Right ventricle