The purpose of this study was to characterize noninvasively left ventricular diastolic filling in patients with coronary artery disease (CAD), by the use of pulsed Dopplerecho. 139 consecutive patients with CAD (with myocardial infarction, MI, n = 110; without MI, n = 29) were included in the study and compared to 67 normal subjects. Analyzing age-matched subgroups, patients with CAD and MI showed a significantly lower peak early diastolic filling velocity (R) as compared to normal subjects. The ratio (E/L) of early (E) to late (L) filling velocity integral as well as the ratio of peak early (R) to peak late (A) filling velocity were significantly lower in patients with MI than in normal subjects. Furthermore, A was lower in patients with MI, as compared to patients without MI. There were no significant differences between patients with single-vessel and multi-vessel disease. The ejection fraction was not significantly related to the diastolic filling parameters. In the normal population (aged 15-66 years) all diastolic filling parameters tested showed a significant correlation with age. The best correlation was found with the E/L ratio (r = -0.63, p less than 0.001). In contrast, there was no significant correlation between age and any of the diastolic filling parameters in patients with CAD. In patients with MI and left ventricular enddiastolic pressure (LVEDP) greater than or equal to 20 mm Hg, E/L was within normal limits, however, and was higher than in patients with LVEDP less than or equal to 14 mm Hg (LVEDP greater than or equal to 20 mm Hg: 2.1 +/- 1.5 SD vs. LVEDP less than or equal to 14 mm Hg: 1.09 +/- 0.38 SD, p less than 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)