155 Assessment of Valsalva maneuver as a method for evaluation of patients with pseudonormalized left ventricular filling pattern

velocity curve for each patient. The results were compared with the MFP. Results: Valsalva maneuver was able to detect a hidden relaxation abnormality in 40% of patients where Em/Am became 1 with slightly prolonged DT and IVRT. Pulsed-wave DTI detected relaxation abnormality in all patients. They had Ea/Aa 0.79±0.11, prolonged DT and IVRT. Group 1 had higher EF (36.71% vs. 32.87%), higher Ea (6.1±0.68 vs 5.3±0.1cm/s), lower Aa (7.9±2.012 vs 8.1±1.91 cm/s) and higher Ea/Aa ratio (0.77 vs 0.65) than group II patients. These data may denote that it was a progression of diastolic dysfunction with or without a hemodynamic factor that was responsible for the persistence of pseudonormalized pattern during Valsalva. Conclusion: Patient uncoperation, less sensitivity, and specificity are the major limitations Valsalva maneuver in assessment of patients with pseudonormalized MFP.Doppler tissue imaging is a simple noninvasive bedside technique with less load dependence. it can be used in combination with MFP for better understanding and assessment of diastolic dysfunctionin those patients. 156 Echocardiographic diastolic dysfunction parameters and mitral regurgitation are predictors of pulmonary hypertension in left ventricular dysfunction.