Association between ventricular repolarization variables and cardiac diastolic function: A cross-sectional study of a healthy Chinese population

Table 1 Clinical, electrocardiography and echocardiographic characteristics based on their E/A ratio

	All subjects (n = 414)	E/A ≥ 0.75 (n = 300)	E/A < 0.75 (n = 114)	P-value
Age (yr)	55.21 ± 14.18	55.25 ± 13.20	69.62 ± 11.05	< 0.001
Male n (%)	186 (44.9%)	124 (41.3%)	62 (55.4%)	0.017
BMI (kg/m2)	23.68 ± 3.00	23.41 ± 2.93	24.37 ± 3.08	0.004
SBP (mmHg)	125.64 ± 12.69	123.05 ± 12.68	132.43 ± 9.93	< 0.001
DBP (mmHg)	75.97 ± 8.84	74.92 ± 8.97	78.73 ± 7.87	< 0.001
TG (mmol/L)	1.38 ± 1.10	1.39 ± 1.18	1.36 ± 0.84	0.840
TC (mmol/L)	5.23 ± 1.05	5.22 ± 1.08	5.26 ± 0.98	0.722
HDL-C (mmol/L)	1.64 ± 0.41	1.65 ± 0.40	1.62 ± 0.44	0.440
LDL-C (mmol/L)	2.90 ± 0.75	2.88 ± 0.76	2.95 ± 0.70	0.448
FBG (mmol/L)	5.55 ± 0.49	5.54 ± 0.48	5.60 ± 0.53	0.248
SCr (μmol/L)	64.37 ± 14.46	62.72 ± 13.23	68.71 ± 16.58	< 0.001
PR interval (ms)	157.08 ± 23.73	156.36 ± 24.18	158.97 ± 22.50	0.302
RR interval (ms)	905.53 ± 126.29	915.40 ± 118.32	879.56 ± 142.52	0.010
QT interval (ms)	372.81 ± 30.07	371.45 ± 29.49	376.39 ± 31.40	0.136
QTc interval (ms)	393.52 ± 29.44	393.59 ± 26.74	403.86 ± 33.56	< 0.001
Tpe interval (ms)	73.94 ± 14.25	72.68 ± 12.41	77.26 ± 17.86	0.003
Tpec interval (ms)	78.27 ± 16.30	76.36 ± 13.53	83.32 ± 21.25	< 0.001
Tpe/QT	0.20 ± 0.03	0.19 ± 0.03	0.20 ± 0.04	0.004
Tpe/QTc	0.19 ± 0.03	0.19 ± 0.03	0.19 ± 0.03	0.160
E (cm/s)	74.36 ± 17.83	80.27 ± 16.20	58.82 ± 11.49	< 0.001
A (cm/s)	75.07 ± 19.21	68.75 ± 16.70	91.69 ± 15.07	< 0.001
E/A	1.07 ± 0.41	1.23 ± 0.36	0.64 ± 0.08	< 0.001
MV-DT (ms)	162.78 ± 35.15	159.43 ± 31.14	171.60 ± 42.92	0.002
LAV (mL)	33.16 ± 9.73	32.30 ± 9.70	35.42 ± 9.48	0.003
LAVI (mL/m2)	19.83 ± 5.31	19.38 ± 5.29	21.01 ± 5.22	0.005
LVEF (%)	62.54 ± 4.71	62.86 ± 4.47	61.68 ± 5.21	0.023

BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; TG: Triglyceride; TC: Total cholesterol; HDL-C-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; SCr: Serum creatinine; E: Early diastolic inflow velocity; A: Late diastolic inflow velocity; DT: E-wave deceleration time; LAV: Left atrial volume; LAVI: Left atrial maximum volume index; LVEF: Left ventricular ejection fraction.

Table 2 Correlation analysis between electrocardiography repolarization variables and other variables

	QT (ms)	QTc (ms)	Tpe (ms)	Tpec (ms)	Tpe/QT	Tpe/QTc
Age (yr)	0.223b	0.281b	0.167b	0.169b	0.109a	0.090
BMI (kg/m2)	0.073	0.109a	0.119a	0.124a	0.120a	0.100a
SBP (mmHg)	0.082	0.167b	0.059	0.089	0.049	0.004
DBP (mmHg)	-0.031	0.029	-0.034	-0.008	-0.005	-0.036
TG (mmol/L)	-0.02	0.028	0.058	0.073	0.086	0.058
TC (mmol/L)	0.009	0.115a	0.054	0.094	0.071	0.020
HDL-C (mmol/L)	-0.061	-0.067	-0.132b	-0.122a	-0.140b	-0.130b
LDL-C (mmol/L)	-0.046	0.155b	0.088	0.127a	0.098a	0.042
FBG ( mmol/L )	-0/089	0.080	0.015	0.074	0.081	0.001
SCr (μmol/L)	-0/013	-0.055	0.089	0.068	0.123a	0.146b
E (cm/s)	0.051	-0.093	-0.072	-0.121a	-0.138b	-0.060
A (cm/s)	0.152b	0.324b	0.189b	0.237b	0.157b	0.079
E/A	-0.070	-0.288b	-0.155b	-0.223b	-0.175b	-0.067
DT (ms)	0.244b	-0.028	0.073	-0.047	-0.039	0.102a
LAV (mL)	0.312b	0.209b	0.157b	0.099a	0.038	0.100a
LAVI (mL/m2)	0.354	0.255b	0.148b	0.091	0.002	0.062

P-values are from analysis of variance:

^aSignificant difference (P < 0.05);

^bSignificant difference (P < 0.01). BMI: Body mass index; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; TG: Triglyceride; TC: Total cholesterol; HDL-C-C: High-density lipoprotein cholesterol; LDL-C: Low-density lipoprotein cholesterol; FBG: Fasting blood glucose; SCr: Serum creatinine; E: Early diastolic inflow velocity; A: Late diastolic inflow velocity; DT: E-wave deceleration time; LAV: Left atrial volume; LAVI: Left atrial maximum volume index.

Table 3 Relationship between electrocardiography repolarization variables and echocardiographic diastolic parameters using a stepwise multiple regression model

	Model 1		Model 2		Model 3
	Beta	P-value	Beta	P-value	Beta	P-value
QT interval (ms)
A (cm/s)	0.152	0.002	0.033	0.435	0.028	0.504
DT (ms)	0.244	< 0.001	0.194	< 0.001	0.182	< 0.001
LAV (mL)	0.312	< 0.001	0.271	< 0.001	0.248	< 0.001
QTc interval (ms)
A (cm/s)	0.324	< 0.001	0.186	< 0.001	0.178	< 0.001
E/A	-0.288	< 0.001	-0.131	0.001	-0.105	0.008
LAV (mL)	0.209	< 0.001	0.152	0.002	0.105	0.019
LAVI (mL/m2)	0.255	< 0.001	0.181	< 0.001	0.142	0.003
Tpe (ms)
A (cm/s)	0.189	< 0.001	0.102	0.015	0.099	0.016
E/A	-0.155	0.002	-0.057	0.153	-0.035	0.355
LAV (mL)	0.157	0.001	0.119	0.014	0.167	0.120
LAVI (mL/m2)	0.148	0.003	0.098	0.039	0.080	0.086
Tpec (ms)
E (cm/s)	-0.121	0.014	-0.062	0.185	-0.032	0.489
A (cm/s)	0.237	< 0.001	0.150	< 0.001	0.143	< 0.001
E/A	-2.223	< 0.001	-0.126	0.002	-0.098	0.010
LAV (mL)	0.099	0.045	0.059	0.233	0.015	0.749
Tpe/QT
E (cm/s)	-0.138	0.005	-0.100	0.030	-0.066	0.152
A (cm/s)	0.157	0.001	0.099	0.017	0.097	0.018
E/A	-0.175	< 0.001	-0.111	0.005	-0.083	0.028
Tpe/QTc
DT (ms)	0.102	0.038	0.078	0.101	0.072	0.139
LAV (mL)	0.100	0.041	0.079	0.100	0.037	0.388

E: Early diastolic inflow velocity; A: Late diastolic inflow velocity; DT: E-wave deceleration time; LAV: Left atrial volume; LAVI: Left atrial maximum volume index. Model 1: Unadjusted model; Model 2: Adjusted for age; Model 3: Fully adjusted for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and serum creatinine. Standardized coefficients and P-values were the outcomes of the regression analyses.

Table 4 Association of E/A ratio within tertiles of QTc and Tpe_c using binary logistic regression model

	Tertile 1				Tertile 2				Tertile 3
	Model 1		Model 2		Model 1		Model 2
	OR (95%CI)	P-value	OR (95%CI)	P-value	OR (95%CI)	P-value	OR (95%CI)	P-value	OR
Tertiles of QTc
Men (n = 186)	0.604 (0.272-1.342)	0.216	0.763 (0.317-1.836)	0.545	0.210 (0.087-0.506)	0.001	0.257 (0.102-0.649)	0.004	1 (ref)
Women (n = 228)	0.527 (0.176-1.579)	0.253	0.982 (0.284-3.396)	0.977	1.230 (0.539-2.806)	0.624	1.480 (0.574-3.815)	0.417	1 (ref)
Tertiles of Tpec
Men (n = 186)	0.890 (0.397-1.996)	0.777	0.980 (0.404-2.372)	0.963	0.465 (0.204-1.061)	0.069	0.423 (0.175-1.022)	0.056	1 (ref)
Women (n = 228)	0.483 (0.188-1.242)	0.131	0.477 (0.162-1.404)	0.179	0.487 (0.204-1.160)	0.104	0.532 (0.200-1.416)	0.206	1 (ref)

Model 1: Adjusted for age; Model 2: Fully adjusted for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, triglyceride, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and serum creatinine. OR values and P-value were the outcome of binary logistic regression using abnormal diastolic function as the dependent variable.