Old and new paradigms on diastolic function in acute myocardial infarction

Although left ventricular systolic function after myocardial infarction has been the subject of detailed studies, diastolic phenomena during and after acute myocardial infarction are less well understood. The reasons for this are that catheterization studies, which are the gold standard, are not practical for serial measurements, whereas Doppler echocardiographic evaluation of diastolic function is based on the assessment of left ventricular filling only rather than on the pressure-volume relation. This article reviews invasive and noninvasive studies of diastolic function after myocardial infarction and proposes an integrated approach to the assessment of systolic and diastolic function that are simultaneously but independently impaired after myocardial infarction.