Table 3.
Associations between Baseline Demographic and Clinical Variables and Incident Diastolic Function or Elevated E/e’
| Variable | Univariable Association with Incident Diastolic Dysfunction by Grade | Multivariable Association with Incident Diastolic Dysfunction by Grade | Univariable Association with E/e’> 14 | Multivariable Association with E/e’>14 | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HR | 95% CI | P-value | HR | 95% CI | P-value | HR | 95% CI | P-value | HR | 95% CI | P-value | |
| Age (years) | 1.0 | (0.8, 1.1) | 0.488 | 1.0 | (0.8, 1.2) | 0.830 | 1.6 | (1.0, 2.5) | 0.031 | 1.5 | (0.9, 2.4) | 0.141 |
| African-American race (Reference = Caucasian) | 1.5 | (1.0, 2.1) | 0.034 | 1.4 | (1.0, 2.1) | 0.083 | 5.0 | (1.9, 12.8) | 0.001 | 4.4 | (1.5, 13.1) | 0.007 |
| Any anti-hypertensive medication | 1.1 | (0.8, 1.6) | 0.572 | 3.4 | (1.3, 8.6) | 0.010 | ||||||
| Angiotensin receptor blocker | 1.3 | (0.7, 2.3) | 0.441 | 2.0 | (0.5, 8.6) | 0.367 | ||||||
| ACE inhibitor | 1.0 | (0.5, 1.8) | 0.886 | 4.8 | (1.7, 13.4) | 0.003 | ||||||
| Beta blocker | 0.7 | (0.4, 1.4) | 0.355 | 5.8 | (2.0, 16.2) | 0.001 | ||||||
| Calcium channel blocker | 1.9 | (11, 3.3) | 0.021 | 7.2 | (2.8, 18.7) | <0.001 | ||||||
| HMG CoA reductase inhibitor | 1.4 | (0.9, 2.3) | 0.183 | 1.8 | (0.5, 6.1) | 0.368 | ||||||
| Diuretics | 1.0 | (0.6, 1.8) | 0.906 | 1.6 | (0.5, 5.4) | 0.479 | ||||||
| Hyperlipidemia | 1.4 | (1.0, 1.9) | 0.090 | 2.3 | (0.9, 6.0) | 0.079 | ||||||
| Hypertension | 1.3 | (0.9, 1.7) | 0.151 | 1.3 | (0.9, 2.0) | 0.151 | 4.9 | (1.8, 13.0) | 0.002 | 2.3 | (0.7, 8.0) | 0.185 |
| Diabetes | 0.8 | (0.4, 1.4) | 0.457 | 0.7 | (0.4, 1.3) | 0.230 | 3.1 | (1.0, 9.5) | 0.045 | 1.5 | (0.4, 5.2) | 0.502 |
| Current smoker | 0.8 | (0.4, 1.7) | 0.647 | 0.7 | (0.3, 1.5) | 0.348 | 6.0 | (1.9, 18.5) | 0.002 | 4.0 | (1.2, 12.9) | 0.022 |
| BMI (5 kg/m2) | 1.0 | (0.9, 1.1) | 0.957 | 1.0 | (0.8, 1.1) | 0.589 | 1.1 | (0.8, 1.5) | 0.626 | 0.7 | (0.5, 1.1) | 0.128 |
| SBP (10 mmHg) | 1.0 | (1.0, 1.1) | 0.366 | 1.5 | (1.1, 2.0) | 0.007 | ||||||
| DBP (10 mmHg) | 1.1 | (1.0, 1.3) | 0.125 | 1.3 | (0.8, 2.2) | 0.218 | ||||||
| Heart rate (10 bpm) | 1.1 | (1.0, 1.2) | 0.085 | 1.1 | (0.8, 1.6) | 0.576 | ||||||
| Doxorubicin (Reference = Trastuzumab) | 0.7 | (0.5, 1.0) | 0.054 | 0.7 | (0.5, 1.1) | 0.092 | 2.2 | (0.5, 10.0) | 0.295 | |||
| Doxorubicin+ Trastuzumab (Reference = Trastuzumab) | 1.0 | (0.6, 1.5) | 0.906 | 0.9 | (0.6, 1.5) | 0.742 | 2.4 | (0.4, 13.0) | 0.318 | |||
| Radiation | 0.5 | (0.3, 0.7) | <0.001 | 0.5 | (0.3, 0.7) | 0.001 | 0.8 | (0.3, 2.2) | 0.657 | |||
BMI refers to body mass index, bpm beats per minute, DBP to diastolic blood pressure, E/e’ to the early mitral inflow peak velocity (cm/sec) divided by the average of the pulsed wave tissue Doppler velocities at the septal and lateral basal regions (cm/sec), HR refers to Hazard Ratio. SBP to systolic blood pressure
Incident diastolic function is defined by abnormal diastolic dysfunction grade amongst participants with normal diastolic function grade at baseline; multivariable analysis includes 249 participants and 184 total abnormal diastolic function grade events. E/e’ refers to time to first E/e’ > 14 in those with and E/e’ 14 at baseline and includes 18 events.
Multivariable model adjusted for age, African American race, hypertension, diabetes, current smoking status, BMI, treatment regimen, and radiation therapy (time-varying).