Older age, female sex, obesity, and higher LV mass were risk factors for incident left atrial dilatation (12% incidence), whereas diuretic use was protective.
Cohort (n=5,375)
Sí
What are the clinical, demographic, and echocardiographic determinants of left atrial dilatation development in hypertensive patients?
In hypertensive patients with initially normal LA size, older age, female sex, obesity, higher LV mass, and worse diastolic function predict LA dilatation, while diuretic use appears protective.
valor p: p=<0.05
BACKGROUND: Left atrial (LA) dilatation is associated with unfavorable outcome in hypertension. However, there are few data on clinical, demographic, and echocardiographic findings correlated with LA dilatation development. METHODS: From the Campania-Salute Network registry, we identified 5,375 hypertensive patients (52±11 years, 38% women) in normal sinus rhythm, with normal LA diameter (parasternal short-axis <24.0 in women and <25.4mm/m in men), with normal left ventricular (LV) ejection fraction, and with at least 12 months of echocardiographic follow-up. We included in the clinic evaluation type of antihypertensive drugs. RESULTS: Follow-up duration was of 70±48 months. During follow-up, 647 patients (12%) showed LA dilatation. Patients with incident LA dilatation were older, most likely to be women, more obese, more diabetics, with lower Modification of Diet in Renal Disease, higher total cholesterol, lower uric acid, higher pulse pressure, lower heart rate, higher LV mass, concentric geometry and lower E/A ratio at mitral level, longer E deceleration time, and higher intima-media carotid thickness. They take more drugs, and follow-up was longer (overall P < 0.05). In the Cox analysis, age, female gender, obesity, higher LV mass, LA diameter at baseline, and longer E deceleration time were determinants of LA dilatation. Furthermore, the use of diuretics protected against LA dilatation. CONCLUSIONS: Our data identify a risk profile for LA dilatation, characterized by older age, female sex, obesity, higher LV mass, and worse diastolic function. In this subgroup of patients, the use of diuretics seems to protect against LA dilatation.
Losi et al. (Wed,) conducted a cohort in Hypertension (n=5,375). Clinical and echocardiographic risk factors vs. Absence of risk factors was evaluated on Left atrial dilatation (p=<0.05). Older age, female sex, obesity, and higher LV mass were risk factors for incident left atrial dilatation (12% incidence), whereas diuretic use was protective.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: