Age: showed negative correlation with E/A ratio in the early presenters and to the E-wave in the normotensives (r=-0.290, P=0.03 and r=0.022 P=0.789 respectively) as shown in the scatter plot (fig 6). It is however correlated positively with the deceleration time in the delayed presenters (r=0.2573, P=0.033). Age also correlated negatively with E/A ratio and E-wave when NDHT were considered as a group (r=-0.177, P=0.01 and r=-0.161, P=0.04) respectively.
Heart rate showed positive correlation with the A and PVF D-waves in normotensive controls (r=0.154, P=0.060, r=0.284 p=0.022 respectively). It was negatively correlated and statistically significant to deceleration time in the delayed presenters (r=–
0.5460 P=0.000) and in NDHT as a group (p=0.001) as shown in the scatter plot (fig 7). No correlation was noted between any of the Doppler indices and heart rate in the early presenters (p>0.05).
Blood pressure – No statistically significant correlation was noted between any of the Doppler diastolic indices and DBP in the early presenters (p>0.05). DBP correlated negatively with the E-wave (r=-0.173 p=0.034) and the Ar-wave (r=-0.204 p=0.030) in the hypertensives as a group. No correlation existed between any of the diastolic function indices and SBP.
ECG LVH. Direct significant correlation was shown with E/A ratio (r=0.2428 p=0.018) in the delayed presenters. It however, correlated negatively with the S-wave (r=-0.2478 p=0.042). None of the Doppler diastolic parameters correlated in the early presenters.
Biochemical parameters
The Total cholesterol correlated with the S (r=-0.425 p=0.003) and D-waves (r=0.368 p=0.012) in hypertensives. The serum triglycerides correlated positively with E/A ratio in the delayed presenters (r = 0.388 p=0.015).
Echocardiographic Parameters
Positive correlation was noted between deceleration time and left ventricular dimension in diastole (r=0.2186 p=0.034).Similarly RST correlated with the isovolumic relaxation time (r=0.2405
p=0.017) in the delayed presenters. The E/A ratio correlated negatively with the RST in the hypertensives (r=-0.17 P=0.003).
Aortic root dimension (ARD) correlated negatively with the E-wave (r=-0.232 p=0.004) and E/A ratio (r=-0.172 p=0.036) in hypertensives.
Left atrial dimension (LAD) was positively correlated with isovolumic relaxation time among the delayed presenters (r=0.0541, p=0.005).
LVMI negatively correlated with the S-wave and S/D ratio in the early presenters respectively (r=-0.3430, p=0.021, r = -0.3190 p=0.033). LVMI however correlated positively in normotensives with the deceleration time (r = 0.192 p=0.019).
4.7: Multiple regression of left ventricular diastolic function parameters and some clinical and Echo variables
Tables 12 and 13 depict the multiple linear regression analysis in the hypertensives and the normotensive controls. Age, ARD and heart rate were the predictors of DD in the hypertensive groups. However age and pulse pressure were the dominant indices in the normotensives.
Table 8: Simple correlation of LV diastolic function parameters and some baseline demographic, biochemical and echocardiographic variables in the hypertensive group.
AGE DBP TC RST HR LVMI ARD
Variable r P r P r p r P r p r P r P
Peak mitral E-wave (m/s)
-0.161 0.04* -0.173 0.034* -0.091 NS -0.096 NS 0.014 NS -0.100 NS -0.232 0.004*
Peak mitral A-Wave (m/s)
0.202 0.013* -0.013 NS 0.000 NS 0.158 NS 0.022 NS 0.008 NS -0.021 NS
E/A Ratio -0.177 0.01* -1070 NS -0.087 NS -0.017 0.003 0.067 NS -0.065 NS -0.172 0.036*
IVRT (ms) 0.012 NS 0.007 NS 0.046 NS 0.109 NS 0.47 NS 0.003 NS 0.146 NS
DT (ms) 0.127 NS -0.100 NS 1.050 NS 0.031 NS -0.282 0.001* 0.076 NS 0.075 NS
AT (ms) -0.034 NS -0.230 0.1005 0.669 NS -0.083 NS -0.083 NS -0.122 0.136 0.098 NS
PVF-S-Wave (m/s)
0.117 0.127 -0.003 0.976 -0.425 0.003* -0.010 NS -0.106 0.263 0.134 NS -0.217 0.021*
PVF-D-wave (m/S)
-0.081 0.795 0.012 NS 0.0368 0.012* -0.042 NS -0.055 0.560 0.031 NS -0.097 NS
S/D ratio -0.006 0.162 -0.019 0.839 0.116 NS 0.063 NS -0.028 NS 0.095 NS -0.115 NS
Atrial reversal 0.162 0.086 -0.204 0.030* -0.064 NS 0.010 NS 0.099 NS 0.051 NS -0.146 NS
DBP-Diastolic Blood Pressure, HR-Heart Rate, TC-Total Cholesterol, RST-Relative Septal Thickness, LVMI-Left Ventricular Mass Index, IVRT-Isovolumic Relaxation Time, DT-Decelaration Time, Aceleration Time, PVF-Pulmonry Venous Flow
* Statistically Significant, NS-Not significant
Table9: Simple correlation analyses of LV diastolic function parameters and age, DBP, PP, HR, RST, ARD, LVMI and Total cholesterol in the Early Presenters.
AGE DBP TC RST HR LVMI ARD
Variable r P r P r p r P r p r P r P
Peak mitral E-wave (m/s)
-0.0838 NS -0.2065 NS 0.0783 NS -0.0980 NS 0.1140 NS -0.0886 NS -0.3121 0.019*
Peak mitral A-Wave (m/s)
0.3334 0.012* 0.1499 NS 0.3060 NS 0.2514 NS 0.185 NS -0.1275 NS 0.218 NS
E/A Ratio -0.2908 0.030* -0.2515 NS -0.2073 NS -0.2748 0.041* 0.276 NS -0.0178 NS -0.2646 0.040*
IVRT (ms) -0.1157 NS 0.0743 NS 0.827 NS 0.1112 NS 0.288 NS 0.0092 NS 0.0659 NS
DT (ms) 0.1036 NS 0.0912 NS 0.1252 NS 0.0500 NS 0.225 NS -.0154 NS 0.1108 NS
AT (ms) -0.1556 NS -.01365 NS 0.0638 NS -0.2208 NS 0.992 NS 0.1205 NS 0.249 NS
PVF-S-Wave (m/s)
-0.1455 NS -0.1260 NS -0.4856 0.019* 0.1138 NS 0.826 NS -0.3430 0.021* -.3800 0.10
PVF-D-wave(m/s)
0.1211 NS 0.1156 NS -0.5824 0.004* 0.1250 0.413 0.601 NS 0.986 NS -0.4349 0.003*
S/D ration 0.0058 NS -0.0453 NS 0.0961 NS 0.0205 NS 0.785 NS 0.822 NS 0.0896 NS
Atrial reversal 0.1113 NS -0.2392 NS -0.0930 NS 0.1603 NS 0.114 NS -0.3190 0.033* -0.3410 0.022*
DBP-Diastolic Blood Pressure, R-Heart Rate, TC-Total Cholesterol, RST-Relative Septal Thickness, LVMI-Left Ventricular Mass Index, IVRT-Isovolumic Relaxation Time, DT-Deceleration Time, Acceleration Time
* Statistically Significant, NS-Not significant
Table 10: Simple correlation analyses of LV diastolic function parameters and age, DBP, PP, HR, RST, ARD, and Triglycerides in the Delayed Presenters.
AGE DBP HR RST TGS PP ARD
Variable r P r P r p r P r P r P R P
Peak mitral E-wave (m/s)
-0.2062 0.040* -0.1097 NS 0.0297 NS -0.1117 NS 0.00573 NS 0.0580 NS 0.1770 0.042*
Peak mitral A-Wave (m/s)
0.1102 NS -0.988 NS -0.0738 NS 0.1020 NS -0.2496 NS 0.0937 NS 0.0522 NS
E/A Ratio -0.1320 NS -0.709 NS 0.1508 NS -0.1476 NS 0.3288 0.015* -0.0611 NS -0.1468 NS
IVRT(ms) 0.0839 NS 0.0255 NS 0.0048 NS 0.2405 0.017* 0.0963 NS 0.0641 NS 0.0106 NS
DT(ms) 0.2573 0.033* -0.0444 NS -0.5460 0.000* 0.0402 NS -0.1484 NS 0.0993 NS 0.1869 NS AT(ms) 0.1039 NS -0.3276 0.006* -0.2266 NS -0.0975 NS 0.1738 NS 0.0668 NS -0.0089 NS
PVF-S-Wave M/s)
-0.0967 NS 0.0693 NS -0.1910 NS 0.0907 NS 0.3119 NS -0.2467 0.043* -0.1102 NS
PVF D-wave (m/s)
-0.0557 NS 0.0462 NS -0.1177 NS -0.1948 NS 0.2451 NS 0.2354 NS -0.1197 NS
S/D -0.167 NS 0.0484 NS -0.1010 NS 0.2002 NS -0.051 NS 0.0332 NS -0.289 NS
Atrial reversal 0.2048 NS 0.1184 NS 0.0009 NS -0.1318 NS 0.4323 NS 0.0910 NS 0.1110 NS
DBP-Diastolic Blood Pressure, R-Heart Rate, TG-Triglyceride, ARD-Aortic Root Dimension, RST-Relative Septal Thickness, LVMI-Left Ventricular Mass Index, IVRT-Isovolumic Relaxation Time, DT-Deceleration Time, Acceleration Time * Statistically Significant, NS-Not significant
Table 11: Simple correlation analysis of LV diastolic function parameters and age, DBP, PP, HR, sex, and ARD in normotensive controls.
AGE DBP SEX PP HR LVMI ARD
Variable r P r P r p r P r p r P r P
Peak mitral E-wave
-0.022 0.789 -0.106 NS -0.138 0.093 -0.181 0.027 -0.049 NS 0.052 NS -0.219 0.007
Peak mitral A-Wave
-0.045 NS 0.002 NS -0.077 NS 0.038 NS 0.154 0.16 0.064 NS -0.137 0.094
E/A Ratio -0.114 NS -0.025 NS -0.132 NS -0.068 0.400 -0.126 NS -0.118 NS 0.048 NS
IVRT(ms) 0.010 NS -0.056 NS 0.106 NS 0.207 0.011* 0.145 NS 0.003 NS 0.068 NS
DT(ms) 0.102 NS -0.048 NS -0.066 0.422 0.054 NS -0.001 NS 0.192 0.019* 0.088 NS
AT(ms) -0.119 NS -0.033 NS 0.026 NS -0.019 NS 0.115 NS -0.026 NS 0.012 NS
PVF S-Wave 0.225 NS -0.159 NS -0.207 NS 0.040 NS -0.158 NS 0.076 NS -0.046 NS
PVF D-wave 0.309 NS -0.049 NS -0.043 NS -0.103 NS 0.284 0.022* 0.086 NS 0.050 NS
S/D -0.127 NS 0.121 NS -0.119 NS 0.112 NS -0.207 NS 0.021 NS 0.044 NS
Atrial reversal -0.015 NS -0.313 0.011* 0.185 NS -0.018 NS 0.203 NS 0.202 NS -0.032 NS
DBP-Diastolic Blood Pressure, HR-Heart Rate, TC-Total Cholesterol, RST-Relative Septal Thickness, LVMI-Left Ventricular Mass Index, IVRT-Isovolumic Relaxation Time, DT-Deceleration Time, AT-Acceleration Time
* Statistically Significant, NS-Not significant
Table I2: Multiple regression analysis of LV diastolic function parameters and Age, aortic root dimension, total cholesterol, heart rate, diastolic blood pressure in the hypertensive group.
Dependent
variable Independent
variable Coefficient P value F P value R2 Peak mitral
E-wave Constant
AGE DBP ARD
106.258 -0.201 -0.198 -0.940
0.000 0.066 0.017 0.010
5.710 0.001 0.105
E/A ratio Constant Age DBP ARD HR TC
0.004 0.735 0.310 0.176 0.530 0.921
8.124 0.546 0.061
Deceleration time
Constant Age ARD HR
213.043 0.495 6.773 0.1985
0.000 0.311 0.495 0.001
4.853 0.003 0.091
Pulmonay venous flow S-wave
Constant ARD TC
63.813 -5.071 -2.926
0.000 0.134 0.004
6.153 0.004 0.004
DBP-Diastolic Blood Pressure, ARD-Aortic Root Dimension, HR-Heart Rate, TC-Total Cholesterol
Table 13: Multiple linear regressions of LV Doppler diastolic function and some clinical and echocardiographic variables in normotensives Dependent
Vairable Independent
Variable Coefficient P value F P value R2 Peak mitral
E-wave
Constant Age PP Sex
83.113 4.838 -0.257 -4.377
0.000 0.722 0.027 0.092
2.639 0.052 0.051
E/A ratio Constant Age PP Sex
1.512 -2.640 -1.610 -7.070
0.000 0.913 0.435 0.128
1.083 0.358 0.022
1VRT Constant BMI PP Sex
48.682 0.694 0.304 2.422
0.000 0.033 0.343 0.009
4.361 0.006 0.082
PP= Pulse Pressure, BMI-Body Mass Index, IVRT-Isovolumic Relaxation Time