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The Tissue Doppler Imaging (TDI) e' wave is an indicator of LV diastolic function. We explored the relationship between the e' wave and hyperglycaemia in a tri-ethnic cohort of white Europeans (E), Indian Asians (IA) and African Caribbean's (AC). Our aim was to determine if varying glucose intolerance is responsible for ethnic differences in e'.Methods: 1335 individuals (aged 69.7±6yrs) underwent 2D echocardiography and TDI. LV dimensions were used to calculate 2D LV mass index. Mitral annular velocities were measured by applying a PW sample volume to the septum and lateral wall. Subjects also underwent CT to image coronary calcium (CAC), had detailed anthropometric measures and a fasted blood glucose test.Results: e' was consistently lower with advancing glucose intolerance in all ethnic groups. e' was significantly attenuated in normoglycaemic AC compared to E, p=0.012 and IA, p=0.004. After adjustment for various covariants (Model 1) there is a strong relationship between fasting blood glucose and e' in IA and AC. This relationship is abolished in the IA group after additional adjustment for LV mass and CAC. e' remained strongly associated with glucose in the AC group after all adjustments (Table).Conclusion: Using TDI we show that hyperglycaemia is associated with a decrease in diastolic function in all three ethnic groups. Fasting glucose is strongly associated with e' in only the AC group after adjusting for all main covariants. This data shows that intrinsic ethnic differences in diastolic function occur with varying glucose intolerance.