Mitral E Wave Deceleration Time to Peak E Velocity Ratio and Cardiovascular Outcome in Hypertensive Patients During Antihypertensive Treatment (from the LIFE Echo-Substudy)

• Published in: The American journal of cardiology 2009-10, Vol.104 (8), p.1098-1104
• Main Authors: Chinali, Marcello, MD, PhD, Aurigemma, Gerard P., MD, de Simone, Giovanni, MD, Mishra, Rakesh K., MD, Gerdts, Eva, MD, PhD, Wachtell, Kristian, MD, PhD, Boman, Kurt, MD, Dahlöf, Björn, MD, PhD, Devereux, Richard B., MD
• Format: Article
• Language: English
• Subjects: Aged; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Blood Flow Velocity - physiology; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Clinical outcomes; Doppler/methods; Drug therapy; Echocardiography; Echocardiography, Doppler - methods; Female; Follow-Up Studies; Heart; Humans; Hypertension; Hypertension - diagnostic imaging; Hypertension - drug therapy; Hypertension - physiopathology; Hypertension/drug therapy/physiopathology/ultrasonography; Hypertrophy; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Left Ventricular/etiology/physiopathology/ultrasonography; Left/physiology; Losartan - therapeutic use; Male; MEDICAL AND HEALTH SCIENCES; Medical sciences; MEDICIN; MEDICIN OCH HÄLSOVETENSKAP; MEDICINE; Mitral Valve - diagnostic imaging; Mitral Valve - physiopathology; Mitral Valve/physiopathology/ultrasonography; Regression analysis; Treatment Outcome; Ventricular Function; Ventricular Function, Left - physiology
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2009.05.063

The early mitral flow deceleration time (DTE) is a prognostically validated marker of left ventricular diastolic dysfunction. It has been reported that the DTE is influenced by the loading conditions, which can vary during antihypertensive treatment. We hypothesized that normalization of the DTE for mitral peak E-velocity (mitral deceleration index [MDI]) might better predict incident cardiovascular (CV) events in hypertensive patients during treatment compared to DTE alone or other traditional indexes of diastolic function, such as the mitral E/A ratio. We evaluated 770 hypertensive patients with electrocardiogram findings of left ventricular hypertrophy (age 66 ± 7 years; 42% women) enrolled in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) echocardiographic substudy. Echocardiographic examinations were performed annually for 5 years during intensive antihypertensive treatment. We examined the utility of the MDI at baseline and as a time-varying predictor of incident CV events. Of the 770 patients, 70 (9%) had CV events. The baseline MDI was positively associated with age and relative wall thickness and negatively associated with gender and heart rate (all p