Background: Pulsed tissue Doppler imaging(TDI) allows direct measurement of systolic and diastolic function of the left ventricle. In patients with coronary artery disease(CAD), myocardial ischemia-related impaired diastolic function may be linked to systemic endothelial damage/dysfunction and increased thrombogenesis. We hypothesized relationships between TDI-defined diastolic dysfunction and plasma von Willebrand factor(vWf, marking endothelial damage/dysfunction), soluble P-selectin(sP-sel, reflecting platelet activation), fibrin D dimer(an index of fibrin turnover and thrombogenesis), fibrinogen, and plasma viscosity(PV) in CAD. Methods: Conventional 2-dimensional Doppler echocardiography and TDI were performed in 75 stable CAD patients(55 men, 59± 11 years) and 40 age-and sex-matched healthy controls. Peak systolic(Sm), peak early(Em), and late(Am) diastolic mitral annular velocities measured at 4 sites(septal, lateral, inferior, and anterior) were averaged as global systolic and diastolic left ventricular function, respectively. The mean TDI velocities were dichotomized into low and high(below/above median) groups. Plasma vWf, sP-sel, D dimer(enzyme-linked immunosorbent assay), fibrinogen(modified Clauss), and PV levels were measured. Results: CAD patients had significantly lower Sm, Em, Em/Am ratio, and a higher ratio of early transmitral flow E-velocity over Em(E/Em) when compared with controls(all P< .05). On multivariate analysis, adjusted for age, ejection fraction, and clinical variables, the differences in the group means of vWf, sP-sel, and fibrinogen remained significantly different between the low and high TDI indexes. D-dimer levels were unrelated to any TDI indexes. None of the transmitral flow indexes were independently related to the research indexes. Conclusions: In patients with CAD, diastolic dysfunction was closely associated with increased platelet activation and endothelial damage/dysfunction independent of systolic function. TDI-derived indexes are more sensitively related to plasma hemostatic markers than transmitral indexes in middle-aged patients with CAD. Background: Pulsed tissue Doppler imaging (TDI) allows direct measurement of systolic and diastolic function of the left ventricle. In patients with coronary artery disease (CAD), myocardial ischemia-related impaired diastolic function may be linked to systemic endothelial damage / dysfunction and increased We hypothesized the relationship between TDI-defined diastolic dysfunction and plasma von Willebrand factor (vWf, marking endothelial damage / dysfunction), soluble P-selectin (sP-sel, reflecting platelet activation), fibrin D dimer (an index of fibrin turnover and Methods: Conventional 2-dimensional Doppler echocardiography and TDI were performed in 75 stable CAD patients (55 men, 59 ± 11 years) and 40 age-and sex-matched healthy controls Peak systolic (Sm), peak early (Em), and late (Am) diastolic mitral annular velocities measured at 4 sites (septal, lateral, inferior, and anterior) were averaged as global systolic and Plasma vWf, sP-sel, D dimer (enzyme-linked immunosorbent assay), fibrinogen (modified Clauss), and PV Results: CAD patients had significantly lower Sm, Em, Em / Am ratio, and a higher ratio of early transmitral flow E-velocity over Em (E / Em) when compared with controls (all P <.05). On multivariate analysis, adjusted for age, ejection fraction, and clinical variables, the differences in the group means of vWf, sP-sel, and fibrinogen significantly differ between the low and high TDI indexes. D-dimer levels were unrelated to any TDI indexes. None of the transmitral flow indexes were independently related to the research indexes. Conclusions: In patients with CAD, diastolic dysfunction was closely associated with increased platelet activation and endothelial damage / dysfunction independent of systolic function. TDI-derived i ndexes are more sensitively related to plasma hemostatic markers than transmitral indexes in middle-aged patients with CAD.