Association Between Inappropriateness of Left Ventricular Mass and Left Ventricular Diastolic Dysfunction: A Study Using the Tissue Doppler Parameter, E/E'.
	    		
		   		
		   			
		   		
	    	
    	 
    	10.4070/kcj.2009.39.4.138
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Young Hyo LIM
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Jae Ung LEE
			        		
			        		;
		        		
		        		
		        		
			        		Kyung Soo KIM
			        		
			        		;
		        		
		        		
		        		
			        		Soon Gil KIM
			        		
			        		;
		        		
		        		
		        		
			        		Jeong Hyun KIM
			        		
			        		;
		        		
		        		
		        		
			        		Heon Kil LIM
			        		
			        		;
		        		
		        		
		        		
			        		Bang Hun LEE
			        		
			        		;
		        		
		        		
		        		
			        		Jinho SHIN
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Cardiology Division, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea. jhs2003@hanyang.ac.kr
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:Original Article
 
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Hypertrophy;
			        		
			        		
			        		
				        		Left ventricle;
			        		
			        		
			        		
				        		Echocardiography
			        		
			        		
	        			
        			
        		
 
        	
            
            	- MeSH:
            	
	        			
	        				
	        				
				        		
					        		Blood Glucose;
				        		
			        		
				        		
					        		Blood Pressure;
				        		
			        		
				        		
					        		Cholesterol;
				        		
			        		
				        		
					        		Deceleration;
				        		
			        		
				        		
					        		Echocardiography;
				        		
			        		
				        		
					        		Fasting;
				        		
			        		
				        		
					        		Heart Ventricles;
				        		
			        		
				        		
					        		Humans;
				        		
			        		
				        		
					        		Hypertension;
				        		
			        		
				        		
					        		Hypertrophy;
				        		
			        		
				        		
					        		Male;
				        		
			        		
				        		
					        		Relaxation
				        		
			        		
	        			
	        			
            	
            	
 
            
            
            	- From:Korean Circulation Journal
	            		
	            		 2009;39(4):138-144
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	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.