title: Mitral deceleration index is associated with aortic root dilatation and not to biventricular structural changes in essential hypertension.
abstract: BACKGROUND AND AIM. The ratio of deceleration time to early mitral wave velocity (mitral deceleration index, MDI) has been recently shown to predict cardiovascular events more precisely than deceleration time alone in human hypertension. Data, however, about the relationship of this parameter with cardiac structure are scant. In the present study, we investigated such an association in uncomplicated essential hypertensives. METHODS. A total of 329 hypertensive subjects categorized in tertiles of MDI were considered for the analysis. All patients underwent the following procedures: (i) physical examination and clinic blood pressure measurement; (ii) routine laboratory investigations; (iii) M-mode, two-dimensional and Doppler echocardiography aimed at a comprehensive assessment of left- and right-sided chambers. RESULTS. Unadjusted left ventricular (LV) mass, right ventricular (RV) and aortic root diameter were significantly higher in the upper MDI tertile, but only aortic root diameter remained significant after adjustment for covariates. A progressive, non-significant increase in biventricular hypertrophy occurred across the MDI tertiles. In a multivariate analysis, MDI was significantly associated with age (β = 0.229, p = 0.001) and aortic root diameter (β = 0.226, p = 0.001); this was not the case for deceleration time alone. No association between MDI and LV as well as RV structural parameters was found. CONCLUSION. Our findings indicate that MDI is unrelated to LV and RV structural changes. Altered LV diastolic function, as assessed by MDI but not by deceleration time alone, is independently associated with aortic root dilatation, a phenotype predictive of incident cardiovascular morbidity and mortality.
authors.affiliation: Department of Clinical Medicine and Prevention, University of Milano-Bicocca, Italy. cesare.cuspidi@unimib.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Francesca
authors.initials: F
authors.lastname: Negri
authors.forename: Carla
authors.initials: C
authors.lastname: Sala
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology*; D012307:Risk Factors; D055815:Young Adult