Hi djis,
Despite all the complicated terms, it sounds like your heart is the same as it was 18 months ago. It is easier to interpret the results after knowing more about your history (previous bypass surgeries, stents, heart attack, etc). I will do my best.
1. There is diffuse global hypokinesis with increase of severity denoting an ischemic component. The mid apical, apical, mid anterior and anterior and anterior septum are more hypokinetic.
--this suggests you have had a blockage in the left anterior descending artery. This is the artery the traverses the front portion of the heart. Other areas of your heart are not moving as well as they should be, but only the left anterior descending artery appears to have been severely blocked.
Septum is paradoxical, most likely secondary to postoperative changes.
--after surgery, the septum (the portion between the left and right ventricle) often has an abnormal bounce. A similar bounce is often seen with left bundle branch blocks as well. This is not something you should worry about.
The ejection fraction with restrictive diastolic dysfunction denoting a stiff myocardium is 40%.
--You heart is pumping out 40% of the blood that enters it. A normal ejection fraction is 50-65%.
--Restriction suggests that your heart is stiff. This may contribute to symptoms of shortness of breath with exertion.
Left atrium is dilated to 4.8 cm with mild mitral insufficiency.
--the left atrium is mildly dilated because of increased pressures, likely related to your stiff ventricle. Mild mitral insuff. is not a concern.
There is aortic valve sclerosis but no stenosis.
--aortic sclerosis occurs with aging. Your valves opens normally.
There is suggestion for right ventricular hypertrophy, dilated right atrium with mild tricuspid insufficiency.
--The right ventricle is thick and the atrium is mildly enlarged. Usually caused by increased right-sided heart pressure, but they were unable to find increased pressures (pulmonary hypertension) on your echo.
You should probably ask your doctor what these results mean for you. They should always be interpreted in context of your personal situation, and mean entirely different things for someone in there 20's versus 80's.
I hope this helps.