Mitral deceleration index is associated with aortic root dilatation and not to biventricular structural changes in essential hypertension

Figures & data

Table I. Clinical characteristics of the study population according to tertiles of mitral E wave deceleration time to peak E velocity ratio (MDI).

Variables	I MDI (1.3–2.7)	II MDI (2.7–3.6)	III MDI (>3.6)	p
n	110	109	110
Age (years)	54.1 ± 13.2	59.5 ± 11.0^d	61.6 ± 11.3^a	<0.01
Male gender (%)	58.7	57.3	69.3	NS
BSA (m^2)	1.84 + 018	1.85 + 018	1.91 + 0.19^c	0.01
BMI (kg/m^2)	26.1 ± 3.7	26.2 ± 3.7	26.7 + 3.8^b	<0.05
Abdominal circum. (cm)	92.5 ± 10.2	93.5 ± 10.8	96.0 ± 11.2^c	<0.01
Clinic SBP (mmHg)	139 ± 14	139 ± 13	139 ± 13	NS
Clinic DBP (mmHg)	87 ± 9	88 ± 9	88 + 10	NS
Clinic HR (b/min)	66 ± 9	67 ± 10	66 ± 10	NS
Duration of HTN (years)	8.3 ± 7.4	8.4 ± 6.4	10.5 ± 8.9^a	<0.01
Blood glucose (mg/dl)	101 ± 32.5	106 ± 25.2	103 ± 19.9	NS
HDL-cholesterol (mg/dl)	60.1 ± 14.7	59.1 ± 18.2	54.6 ± 15.2	NS
Triglycerides (mg/dl)	122 ± 65.1	133 ± 73.3	142 ± 116.0	NS
Creatinine (mg/dl)	1.02 ± 0.28	1.04 ± 0.25	1.06 ± 0.22	NS
Uric acid (mg/dl)	5.2 ± 1.6	5.6 ± 1.5	5.8 ± 1.3	NS
Obesity (%)	16.5	14.5	18.9^e	< 0.05
DM (%)	5.1	13.3	14.6	NS
Current smoking (%)	18.5	13.6	9.1	NS
Sokolow–Lyon (mm)	20.5 ± 6.0	19.9 ± 5.9	19.0 ± 5.4	NS
Untreated (%)	12.8	10.9	7.2	NS
Beta-blockers (%)	30.3	25.4	25.2	NS

Data are shown as means ±SD or %; BSA, body surface area; BMI, body mass index; SBP/DBP, systolic/diastolic blood pressure; HR, heart rate; HTN, hypertension; HDL, high-density lipoprotein; DM, diabetes mellitus; ^ap < 0.01 III vs I; ^bp < 0.05 III vs I; ^cp < 0.01 III vs II, I; ^dp < 0.05 II vs I; ^ep < 0.05 III vs II.

Table II. Echo-Doppler parameters of the study population according to tertiles of mitral deceleration index (MDI).

Variables	I MDI (1.3–2.7)	II MDI (2.7–3.6)	III MDI (>3.6)	p
n	110	109	110
LVIDd (mm)	48.3 ± 3.7	48.2 ± 4.1	49.6 ± 3.4^c	<0.01
IVSTd (mm)	9.9 ± 1.3	10.3 ± 1.3^d	10.5 ± 1.3^a	<0.01
PWTd (mm)	8.8 ± 1.0	9.0 ± 0.9	9.3 ± 0.9^a	<0.01
LV-RWT	0.39 ± 0.04	0.40 ± 0.05^d	0.40 ± 0.05	<0.05
LA long axis (mm)	46.8 ± 4.5	46.6.2 ± 4.4	47.6 ± 4.8	NS
Aortic root (mm)	32.8 ± 3.5	33.8 + 4.3	35.4 ± 4.1^c	<0.01
LV mass (g)	185 ± 49.9	194 ± 47.1	207 ± 45.3^c	<0.01
LV mass index (g/h^2.7)	45.1 ± 11.0	46.7 ± 10.1	48.4 ± 9.9^b	<0.05
MWS (%)	20.2 ± 1.9	19.5 + 2.1^d	19.3 ± 2.3^a	<0.01
(E/A)M ratio	1.2 ± 0.36	1.05 ± 0.33^d	0.85 ± 0.27^c	<0.001
DTm (ms)	181 ± 26.6	218 ± 32.9^d	268 ± 51^c	<0.001
RVDd outflow (mm)	25.9 ± 3.8	26.8 ± 4.2	27.8 ± 3.8^a	<0.01
RVTd outflow (mm)	5.3 ± 1.1	5.4 ± 1.0	5.5 ± 0.9	NS
RA long axis (mm)	44.9 ± 4.2	44.8 ± 3.9	45.5 ± 3.9	NS
TAPSE (cm)	2.6 ± 0.4	2.5 ± 0.5	2.5 ± 0.0.4	NS
(E/A)T ratio	1.39 ± 0.33	1.31 ± 0.33	1.18 ± 0.36^c	<0.01
DTt (ms)	212 ± 50.9	218 ± 64.9	238 ± 60.6^c	<0.01

LVIDd, left ventricular internal diastolic diameter; IVSTd, interventricular septum thickness in diastole; PWTd, posterior wall thickness in diastole; LV, left ventricular; RWT, relative wall thickness; LA, left atrium; LVM, left ventricular mass; MWS, mid-wall shortening fraction; Em, early diastolic mitral flow; Am, late diastolic mitral flow; DT, deceleration time; RVDd, right ventricular diastolic diameter; RVTd, right ventricular diastolic thickness; Et, early diastolic tricuspid flow; At, late diastolic tricuspid flow; RA, right atrium. TAPSE, tricuspid annular plane systolic excursion. ^ap < 0.01 III vs I; ^bp < 0.05 III vs I; ^cp < 0.01 III vs II, I; ^dp < 0.05 II vs I.

Table III. Univariate and multivariate correlations between mitral deceleration index (MDI) and clinical and echocardiographic variables.

	Univariate analysis		Multivariate analysis
Variable	r	p	β	p
Age	0.31	<0.0001	0.229	0.001
BSA	0.12	0.03	0.033	NS
Clinic SBP	0.02	NS	–	–
Clinic DBP	0.03	NS	–	–
Clinic HR	−0.12	0.04	0.109	NS
Duration HTN	0.14	0.009	0.020	NS
Plasma glucose	0.09	NS	–	–
HDL-cholesterol	−0.14	0.02	−0.126	0.03
Serum creatinine	0.07	NS	–	–
LV mass	0.21	<0.0001	0.029	NS
LV-RWT	0.08	NS	–	–
Mid-wall shortening	0.09	NS	–	–
Aortic root	0.31	<0.0001	0.226	0.001
LA diameter	0.15	0.006	0.048	NS
RVTd (outflow)	0.15	0.005	0.021	NS
(E/A)T	0.19	<0.0001	−0.168	0.01

For abbreviations, see Tables I and II.