Association Between Inappropriateness of Left Ventricular Mass and Left Ventricular Diastolic Dysfunction: A Study Using the Tissue Doppler Parameter, E/E'

BACKGROUND AND OBJECTIVES The structural significance of the inappropriateness of left ventricular mass (iLVM) is known to be an important prognostic factor for cardiovascular events; however, the functional changes associated with iLVM have not been established. This study was performed to determine if diastolic dysfunction is associated with iLVM using a tissue Doppler technique. SUBJECTS AND METHODS Three hundred sixty consecutive subjects, including 221 hypertension patients from the echocardiography database, were analyzed. Regarding the appropriateness of left ventricular (LV) mass, an observed/predicted ratio of LV mass (OPR) >130% was defined as inappropriate. Echocardiographic parameters, including early diastolic peak velocity (E)/late diastolic peak velocity (A), deceleration time (DT), isovolumetric relaxation time (IVRT), and E/early mitral annulus velocity (E'), were compared between the appropriate LV mass (aLVM) group and the iLVM group. RESULTS Among transmitral flow parameters, only the E velocity was negatively correlated with the OPR when adjusted for age (adjusted r=-0.107, p=0.04). Based on multiple regression analysis, the OPR (beta=0.163, p=0.003), as well as age (beta=0.286, p=0.0001), systolic blood pressure (beta=0.120, p=0.019), fasting blood glucose (beta=0.098, p=0.042), and male gender (beta=0.157, p=0.002) were independent factors determining E/E'. The cholesterol level was not an independent factor (beta=-0.059, p=0.355). In the iLVM group (n=105), the adjusted E/E' was higher than in the aLVM group (n=255; 11.7+/-3.4 vs. 10.8+/-3.1, p=0.02), while the peak E flow velocity was significantly lower than in the aLVM group (70.9+/-15.1 vs. 75.5+/-17.6, p=0.03). CONCLUSION Inappropriateness of LV mass is independently associated with increased E/E'. Thus, E/E' may be a useful parameter for the evaluation of diastolic dysfunction.