Sixty three patients with endemic fluorosis (36 males/27 females; mean age 33.9 +/- 8.6 years) and 45 age, sex and body mass index (BMI) matched healthy controls (30 males/15 females; mean age 32.7 +/- 8.8 years) were included in this study. Basic echocardiographic measurements, left ventricular diastolic parameters and left ventricular myocardial performance index (MPI) were measured. The left ventricular MPI was calculated as (isovolumic contraction time + isovolumic relaxation time)/aortic ejection time by Doppler. The urine fluoride levels of fluorosis patients were significantly higher than control subjects as expected (1.9 +/- 0.1 mg/l vs 0.4 +/- 0.1 mg/l respectively; P<0.001). Isovolumic relaxation time (IVRT) and deceleration time (DT) were significantly higher in fluorosis patients than in controls (for IVRT 106.9 +/- 15.6 ms vs 96.7 +/- 12.2 ms; P<0.001 and for DT 211.7 +/- 30.7 ms vs 188.0 +/- 30.0 ms; P<0.001, respectively). MPI was significantly higher in fluorosis patients than in controls (0.62 +/- 0.15 ms vs 0.49 +/- 0.10 ms; P<0.001, respectively). We have shown that chronic fluorosis patients had left ventricular diastolic and global dysfunctions. (C) 2010 Elsevier B.V. All rights reserved.