[Left ventricular diastolic behavior in patients with syndrome X during isometric exercise assessed by Doppler...

Left ventricular (LV) diastolic filling during isometric exercise was evaluated in patients with syndrome X using pulsed Doppler echocardiography. The handgrip exercise was performed by 12 normal subjects (group N), 14 patients with syndrome X (group X), and 20 patients with effort angina, who were divided into 13 patients with single vessel disease (group SVD) and seven patients with multiple vessel disease (group MVD). The transmitral inflow patterns before and at the end of exercise were recorded using Doppler flowmetry, to measure the peak velocity of early diastolic flow (E) and the peak velocity of atrial contraction flow (A). The A/E ratio and the % change in A/E (% A/E) at the end of exercise compared with those before were calculated. 1. Group N: E, A, and A/E did not change significantly. 2. Group X: E decreased, A increased, and A/E increased. 3. Group SVD: E did not change significantly. A increased, and A/E increased. 4. Group MVD: E decreased, A increased, and A/E increased. 5. % A/E in group X and group MVD were larger than in group SVD. 6. Systolic blood pressure (SBP) and heart rate (HR) increased during exercise to the same extent in each group. The impairment of LV diastolic filling in group X was more severe than in group SVD, possibly due to more extensive ischemic areas in group X than in group SVD. The extension of ischemic areas in syndrome X may be similar to that in group MVD.