Backgroud:Left ventricular(LV)remodeling is a continuous and progressive process even after revascularization for acute myocardial infarction(MI).There is a limited data about influence of remodeling on echoparametric changes in response to stress.Methods:Conventional echocardiography was performed after primary revascularization in 31patients with ST segment elevation MI and after then,dobutamine stress echocardiography(DSE)with tissue Doppler image(TDI)was examined 4months after index infarction.Transmitral inflow pattern and mitral annular velocities with TDI at septum were obtained.Transmitral to mitral annular early diastolic velocity ratio(E/Em)was derived.Results:11patients with LV remodeling(>10%increase in end diastolic volume)had improved ejection fraction(EF),mitral annular systolic velocity(Sm),despite unchanged E/Em,regional wall motion score index(RWMSI)for follow-up duration.During DSE,compared with patients without LV remodeling,those with LV remodeling showed lower augmentation of Sm and EF.RWMSI in patients with LV remodeling didn't improve during stress phase.While E/Em in those without remodeling didn't change significantly,an increased E/Em was identified during peak stress phase(9.90vs14.67;p=0.033).There had a trend toward worsening as regards the degree of change in E/Em during stress and recovery(p=0.072,p=0.044 respectively).Conclusion:LV Remodeling after revascularization would be observed,despite improved systolic function.LV remodeling could disclose and bring about further diastolic dysfunction,especially during stress.