The aim of the present study was to investigate whether slowing of mitral-to-apical filling is present in patients with acute myocardial infarction (AMI). Twenty-eight patients with their first AMI were examined by color M-mode Doppler echocardiography. Twenty-eight age- and sex-matched healthy individuals served as control subjects. From the color M-mode Doppler images, we measured the time difference (TD) between occurrence of peak flow velocity at the mitral tip and in the apical region by a blinded analysis. The TD was increased in the AMI group compared with the control subjects (70 +/- 60 versus 40 +/- 30 msec, p = 0.02) and correlated with peak SGOT (r = 0.46, p = 0.02) and age (r = 0.57, p < 0.01). In the 15 patients with anterior AMI, the correlation between TD and SGOT was better (r = 0.68, p < 0.01). This study demonstrated slowing of early diastolic mitral-to-apical flow propagation in patients with AMI. Infarction size and age appear to be of importance for the retardation of mitral-to-apical flow propagation.